MATI DOCTORS COLLEGE

Matiao National Highway, Mati City, Davao Oriental Tel. No. 087-3883-761 fax No. 087-3883-714 E-Mail Address: matidoctorscollege@yahoo.com SURGICAL SCRUB in ST. CAMILLUS HOSPITAL OF MATI FOUNDATION, INC., City of Mati, Davao Oriental Hospital, Municipality/City/Province Prepared by: Printed Name and signature of student: MARK ELBEN G. TEODORO

Date performed and Time Started

December 5, 2011 8:45am

Patients Initial Only Case Number

SURGICAL PROCEDURE PERFORMED

O.R Nurse On Duty (Name and Signature)

SUPERVISED BY Clinical Instructor (Name and Signature)

Mrs. N. D. 1143302

Total Abdominal Hysterectomy Aneleu M. Bernido, R.N. PRC No.:0206909 Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

December 5, 2011 11:02pm

Mrs. J.B. 1140182 Mrs. L.P. Low Segment Transverse Cesarean Section Aneleu M. Bernido, R.N. PRC No.:0206909 Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

December 22, 2011 12:07pm

Hernioraphy right (RUV) 49518 1143605 Aneleu M. Bernido, R.N. PRC No.:0206909 Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Noted by: LUZMINDA B. ARPON, R.N., M.A.N., DO.D.T. (Print Name and Signature) Clinical Coordinator, PRC I.D No. 0065946 Date document is signed: Valid Until : October 24, 2012 Time:

Approved by: HANEDINA P. TEODORO, R.N., M.A.N. (Print Name and Signature) Dean, PRC I.D No.0057947 Date document is signed: Valid Until May 14, 2015 Time

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

MATI DOCTORS COLLEGE

Matiao National Highway, Mati City, Davao Oriental Tel. No. 087-3883-761 fax No. 087-3883-714 E-Mail Address: matidoctorscollege@yahoo.com SURGICAL SCRUB in ST. CAMILLUS HOSPITAL OF MATI FOUNDATION, INC., City of Mati, Davao Oriental Hospital, Municipality/City/Province Prepared by: Printed Name and signature of student__ _MARK ELBEN G. TEODORO

Date performed and Time Started

Patients Initial Only Case Number

Mr. A.Q.

PROCEDURE PERFORMED

O.R Nurse On Duty (Name and Signature)

SUPERVISED BY Clinical Instructor (Name and Signature)

September 9, 2011 10:14am

External Laparotomy left, Hemicolectomy 1019352 Mr. A.V. Aneleu M. Bernido, R.N. PRC No.:0206909 Appendectomy 1141638 Mr. S. S. Aneleu M. Bernido, R.N. PRC No.:0206909 Small Incision Senile Cataract Surgery with Intraocular Lens Left Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979 Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

October 13, 2011 2:06pm

October 28, 2011 2:47pm

1142049

Aneleu M. Bernido, R.N. PRC No.:0206909

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Noted by: LUZMINDA B. ARPON, R.N., M.A.N., DO.D.T. (Print Name and Signature)

Approved by: HANEDINA P. TEODORO, R.N., M.A.N. (Print Name and Signature)

Clinical Coordinator, PRC I.D No. 0065946 Date document is signed:

Valid Until : October 24, 2012 Time:

Dean, PRC I.D No.0057947 Date document is signed:

Valid Until May 14, 2015 Time

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

MATI DOCTORS COLLEGE

Matiao National Highway, Mati City, Davao Oriental Tel. No. 087-3883-761 fax No. 087-3883-714 E-Mail Address: matidoctorscollege@yahoo.com ACTUAL DELIVERY in City of Mati Balay Paanakan, Mati City, Davao Oriental and in Well Family Midwife Clinic, Mati City, Davao Oriental Hospital, Municipality/City/Province Prepared by: Printed Name and signature of student__ _MARK ELBEN G. TEODORO

Date performed and Time Started

May 28, 2012

Patients Initial Only Case Number

Mrs. D.D. 106 Mrs. J.B. 128 Mrs. R.D.C. 00-6788

PROCEDURE PERFORMED Actual Handled

Normal Spontaneous Vaginal Delivery

D.R. Nurse/Midwife On Duty (Name and Signature)

SUPERVISED BY Clinical Instructor (Name and Signature)

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

June 25, 2012

Normal Spontaneous Vaginal Delivery Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979 Normal Spontaneous Vaginal Delivery Sarah E. Manansala, P.G., R.M. PRC 0006146 Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

July 7, 2012 7:25am

Noted by: LUZMINDA B. ARPON, R.N., M.A.N., DO.D.T. (Print Name and Signature) Clinical Coordinator, PRC I.D No. 0065946 Date document is signed: Valid Until : October 24, 2012 Time:

Approved by: HANEDINA P. TEODORO, R.N., M.A.N. (Print Name and Signature) Dean, PRC I.D No.0057947 Date document is signed: Valid Until May 14, 2015 Time

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

MATI DOCTORS COLLEGE

Matiao National Highway, Mati City, Davao Oriental Tel. No. 087-3883-761 fax No. 087-3883-714 E-Mail Address: matidoctorscollege@yahoo.com ACTUAL DELIVERY in Well Family Midwife Clinic, Mati City, Davao Oriental Hospital, Municipality/City/Province Prepared by: Printed Name and signature of student__ _MARK ELBEN G. TEODORO

Date performed and Time Started

April 26, 2012 2:11am

Patients Initial Only Case Number

Mrs. M.J.R.L 00-6733

PROCEDURE PERFORMED Assisted Delivery

Normal Spontaneous Vaginal Delivery

D.R. Midwife On Duty (Name and Signature)

SUPERVISED BY Clinical Instructor (Name and Signature)

Sarah E. Manansala, P.G., R.M. PRC 0006146 July 8, 2012 7:00pm Mrs. T.R.R.L 00-6656 Normal Spontaneous Vaginal Delivery Sarah E. Manansala, P.G., R.M. PRC 0006146 July 12, 2012 8:45am Mrs. C.M.A. 00-6786 Normal Spontaneous Vaginal Delivery Sarah E. Manansala, P.G., R.M. PRC 0006146

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Noted by: LUZMINDA B. ARPON, R.N., M.A.N., DO.D.T. (Print Name and Signature)

Approved by: HANEDINA P. TEODORO, R.N., M.A.N. (Print Name and Signature)

Clinical Coordinator, PRC I.D No. 0065946 Date document is signed:

Valid Until : October 24, 2012 Time:

Dean, PRC I.D No.0057947 Date document is signed:

Valid Until May 14, 2015 Time

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

MATI DOCTORS COLLEGE

Matiao National Highway, Mati City, Davao Oriental Tel. No. 087-3883-761 fax No. 087-3883-714 E-Mail Address: matidoctorscollege@yahoo.com IMMEDIATE NEWBORN CORD CARE in Well Family Midwife Clinic, Mati City, Davao Oriental Hospital, Municipality/City/Province Prepared by: Printed Name and signature of student__ _MARK ELBEN G. TEODORO

Date performed and Time Started

Patients Initial Only Case Number

Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, NICU, or Home
Delivery Room

D.R. Midwife On Duty (Name and Signature)

SUPERVISED BY Clinical Instructor (Name and Signature)

April 25, 2012 1:25am

Baby Boy 00-6166

Sarah E. Manansala, P.G., R.M. PRC 0006146 June 29, 2012 1:45pm Baby Girl 00-6208 Delivery Room

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Sarah E. Manansala, P.G., R.M. PRC 0006146

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

June 29, 2012 4:00pm

Baby Boy 00-6783

Delivery Room

Sarah E. Manansala, P.G., R.M. PRC 0006146

Norenn Joy T. Fuertes, R.N.,R.M., M.A.N. PRC No.: 0432979

Noted by: LUZMINDA B. ARPON, R.N., M.A.N., DO.D.T. (Print Name and Signature) Clinical Coordinator, PRC I.D No. 0065946 Date document is signed: Valid Until : October 24, 2012 Time:

Approved by: HANEDINA P. TEODORO, R.N., M.A.N. (Print Name and Signature) Dean, PRC I.D No.0057947 Date document is signed: Valid Until May 14, 2015 Time

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing

Please specify Highest Nursing Degree Earned: Master of Arts in Nursing