Asia Pacific College of Advanced Studies City of Balanga, Bataan

Name of Student: Kie Ann Irish L. Rodriguez Name & Address of School: Asia Pacific College of Advanced Studies City of Balanga Accreditation Level (if any): Date School/Program was Recognized: March 21, 2007 First Course (if any): Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): March 2012

Year Granted: Number: 1993 School Graduated From:

Year: Year:

I. Major Operations No .
1 2

Date of Operati on
05 - 16 2011 01 - 05 2012 01 - 05 2012

Case No.
165527 175846

Name of Patient
Josephine Esumadia Rebecca Adraneda

Diagnosis

Operation Performe d
LTCS + BTL MRM (Left) ; JP Drainage (Left) Pinning,4th metacarpal (right) ; SAPM (right)

Type of Anesthe sia

Spinal GAET

Name of Surgeon
Dra.Valledor Dr. Romeo Alcantara Dr. Frank Detabali Dr. Romeo Alcatara

Name of Hospital
Bataan General Hospital Bataan General Hospital Bataan General Hospital

Name of O.R. Scrub Nurse

Signature of O.R. Scrub Nurse

Previous CS Ivasive Ductal CA (Left) Closed fraction; 4th metacarpal (Right)

169994

Mark Francis Ramos

GA Mask

Noted by: Evelyn R. Rubia Signature over printed name Chief Nurse Date Signed: Degree: BSN, PhD a. PRC No.: 0098006 Valid until: Oct. 22, 2014 b. PNA No.: 7845 Valid until : Life Member Meliza S. San Agustin Signature over printed name Clinical Coordinator Date Signed: Degree: BSN, PhD a. PRC No.: 0318862 Valid until: May 5, 2014 b. PNA No.: 18751 Valid until: Life Member Raquel A. Leongson Signature over printed name Dean, College of Nursing Date Signed: Degree: BSN, MAN a. PRC No.: 0199751 Valid until: August 5, 2014 b. PNA No.: 18570 Valid until: Life Member

Asia Pacific College of Advanced Studies City of Balanga, Bataan

c. ADPCN No: 0753 Valid until - 2012

Name of Student: Kie Ann Irish L. Rodriguez Name & Address of School: Asia Pacific College of Advanced Studies City of Balanga Accreditation Level (if any): Date School/Program was Recognized: March 21, 2007 First Course (if any): Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): March 2012

Year Granted: Number: 1993 School Graduated From:

Year: Year:

II. Circulating Nurse in Major Operation

No . Date of Operatio n
01 - 26 2011

Case No.

Name of Patient

Diagnosis
PU del to live term bb(F) by LTCS primary for frank breech presentation G1P1 (1001) Inguinal Hernia (Right) Abdominal uterine bleeding; s/p fractional curettage (Decidual changes) ; Failed medical management ; G5P5 (5005)

Operation Performed

Type of Anesthesia

Name of Surgeon

Name of Hospital
Bataan General Hospital Bataan General Hospital

Name of O.R. Scrub Nurse

Signature of O.R. Scrub Nurse

161057

Monaliza Marasigan

E LTCS Primary Herniorrhaphy (right) with mesh overlay lichtenstein

Spinal

Dra. Medina

05 - 17 2011

165559

Francisco Valdecanas

Spinal

Dr. Romeo Alcantara Dr. Karen Medina

11 - 22 2011

164833

Imelda Ongoco

TAHBSO

Spinal

Dr. Andy Paningbatan Dra. Emilita Firmacion

Bataan General Hospital

Noted by:

Asia Pacific College of Advanced Studies City of Balanga, Bataan

Evelyn R. Rubia Signature over printed name Chief Nurse Date Signed: Degree: BSN, PhD a. PRC No.: 0098006 Valid until: Oct. 22, 2014 b. PNA No.: 7845 Valid until: Life Member

Meliza S. San Agustin Signature over printed name Clinical Coordinator Date Signed: Degree: BSN, PhD a. PRC No.: 0318862 Valid until: May 5, 2014 b. PNA No.: 18751 Valid until: Life Member

Raquel A. Leongson Signature over printed name Dean, College of Nursing Date Signed: Degree: BSN, MAN a. PRC No.: 0199751 Valid until: August 5, 2014 b. PNA No.: 18570 Valid until: Life Member c. ADPCN No: 0753 Valid until: 2012

Kie Ann Irish L. Rodriguez Name & Address of School: Asia Pacific College of Advanced Studies City of Balanga Accreditation Level (if any): Date School/Program was Recognized: March 21, 2007 First Course (if any): Year of Admission in the Bachelor of Science in Nursing Program: June 2007 Year Graduated (BSN Program): March 2011
Name of Student:

Year Granted: Number: 1993 School Graduated From:

Year: Year:

III. Actual Normal Deliveries No . Case No. Diagnosis

Pregnancy Uterine Delivered Spontaneously to an alive Baby Boy Cephalic term G1P0 38-39 weeks AOG Pregnancy Uterine Delivered Spontaneously to an alive Baby Boy Cephalic term G2P2

Name of Mother

Ag e

Date of Deliver y

Time of Delivery

Gender of Baby

Hospital

Type of Delive ry
NSD

Supervised by: Signature of OR/DR Supervisor

1 2

162473

Roshiel Diaz

25

02-28-11

5:00 pm

Male

Bataan General Hospital

162837

Nova Corpuz

29

03-09-11

9:46 am

Male

Bataan General Hospital

NSD

Asia Pacific College of Advanced Studies City of Balanga, Bataan

38-39 weeks AOG Pregnancy Uterine Delivered Spontaneously to an alive Baby Boy Cephalic term G2P2 38-39 weeks AOG

115286

Jocelyn Veloso

26

04-12-11

3:50 pm

Male

Bataan General Hospital

NSD

Noted by: Evelyn R. Rubia Signature over printed name Chief Nurse Date Signed: Degree: BSN, PhD a. PRC No.: 0098006 Valid until: Oct. 22, 2014 b. PNA No.: 7845 Valid until: Life Member Meliza S. San Agustin Signature over printed name Clinical Coordinator Date Signed: Degree: BSN, PhD a. PRC No.: 0318862 Valid until: May 5, 2014 b. PNA No.: 18751 Valid until: Life Member Raquel A. Leongson Signature over printed name Dean, College of Nursing Date Signed: Degree: BSN, MAN a. PRC No.: 0199751 Valid until: August 5, 2014 b. PNA No.: 18570 Valid until: Life Member c. ADPCN No: 0753 Valid until : 2012

Name of Student: Kie Ann Irish L. Rodriguez Name & Address of School: Asia Pacific College of Advanced Studies City of Balanga Accreditation Level (if any): Date School/Program was Recognized: March 21, 2007 First Course (if any): Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): March 2012

Year Granted: Number: 1993 School Graduated From:

Year: Year:

IV. Deliveries Assisted

Asia Pacific College of Advanced Studies City of Balanga, Bataan

No . 1 2 3 Case No.
110812 164239 145201

Diagnosis

Name of Mother
Shaila Dela Rosa Joeriz Flores Leonora Malibiran

Age
36 28

Date of Deliv ery

03-0811 04-1211 01-1410

Time of Delive ry
9:10 am 7:30 pm 9:29

Gender of Baby
Male Male Male

Hospital
Bataan General Hospital Bataan General Hospital Bataan General Hospital

Type of Delive ry
NSD NSD NSD

Supervised by: Signature of Qualified C.I.

Meliza S. San Agustin Meliza S. San Agustin Meliza S. San Agustin

Noted by Evelyn R. Rubia Signature over printed name Chief Nurse Date Signed: Degree: BSN, PhD a. PRC No.: 0098006 Valid until: Oct. 22, 2011 b. PNA No.: 7845 Valid until: Life Member Meliza S. San Agustin Signature over printed name Clinical Coordinator Date Signed: Degree: BSN, PhD a. PRC No.: 0318862 Valid until: May 5, 2014 b. PNA No.: 18751 Valid until: Life Member Raquel A. Leongson Signature over printed name Dean, College of Nursing Date Signed: Degree: BSN, MAN a. PRC No.: 0199751 Valid until: August 5, 2011 b. PNA No.: 18570 Valid until: Life Member c. ADPCN No: 0753 Valid until: 2011

Name of Student: Kie Ann Irish L. Rodriguez Name & Address of School: Asia Pacific College of Advanced Studies City of Balanga Accreditation Level (if any): Date School/Program was Recognized: March 21, 2007 First Course (if any): Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): March 2012

Year Granted: Number: 1993 School Graduated From:

Year: Year:

Asia Pacific College of Advanced Studies City of Balanga, Bataan

V. Cord Dressing No . 1 2 3 Case No.
152404 152655 135058

Date Perform ed
07-08-10 07-15-10 01-10-12

Name of Baby
Baby Mangonan Baby Munoz Baby Agustin

Gen der
Femal e Male Male

Name of Mother
Marites Mangonan
Cecille Munoz

Age
32 29 25

Hospital
Bataan General Hospital Bataan General Hospital Bataan General Hospital

Supervised by: Signature of Qualified C.I.

Maria Concepcion Agustin

Noted by: Evelyn R. Rubia Signature over printed name Chief Nurse Date Signed: Degree: BSN, PhD a. PRC No.: 0098006 Valid until: Oct. 22, 2014 b. PNA No.: 7845 Valid until: Life Member Meliza S. Panganiban Signature over printed name Clinical Coordinator Date Signed: Degree: BSN, PhD a. PRC No.: 0318862 Valid until: May 5, 2014 b. PNA No.: 18751 Valid until: Life Member Raquel A. Leongson Signature over printed name Dean, College of Nursing Date Signed: Degree: BSN, MAN a. PRC No.: 0199751 Valid until: August 5, 2014 b. PNA No.: 18570 Valid until: Life Member c. ADPCN No: 0753 Valid until: 2012