PROFESSIONAL REGULATION COMMISSION

MANILA
BOARD OF MIDWIFERY
RECORD OF ACTUAL DELIVERIES HANDLED

Please check if applicant is:

___/___Graduate Midwife _______Registered Nurse
Name of Applicant:MOPAK, REBECCA DONDOK School: VMC ASIAN COLLEGE FOUNDATION, Tacurong City, SultanKudarat

Name and Date/Time Full Name, Address & Contact Printed Name of CI Position/ License No./
Address of Patient Case No. Complete Diagnosis Performed Number of Facility and Contact Number Designation Signature Expiry Date
1. PIMENTEL, JENEVIE T. Jenevie, 22 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine 39 March 1, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Kanulay, Bagumbayan, Sultan 3/7weeks age of gestation, Cephalic in Labor, delivered thru normal 4:30 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 2103-0222 spontaneous vaginal delivery to an alive baby boy, Apgar Score = 8-9 0917-525-8870 0906-934-1969 2024
Birth weight = 3,200 grams.
2. CAMPO, ROHANA M. Rohana, 25 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 4/7 March 5, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Nakan, Bagumbayan, Sultan weeks age of gestation, Cephalic in Labor, delivered thru normal 12:30 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 2103-0236 spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 2024
Birth weight = 2,700grams.
3. BAUTISTA, CRYSTYL C. Crystyl, 27 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy uterine 40 March 8, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Monteverde, Bagumbayan, Sultan weeks age of gestation, Cephalic in Labor, delivered thru normal 7:29 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 2103-0242 spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 2024
Birth weight =3,000 grams.
4. KULAT, JULIET S. Juliet, 23 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine 39 5/7 March 11, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Daguma, Bagumbayan, Sultan 2103-0252 weeks age of gestation, Cephalic in Labor, delivered thru normal 10:20 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat spontaneous vaginal delivery to an alive baby boy, Apgar Score = 8-9 0917-525-8870 0906-934-1969 2024
Birth weight =3,200 grams.
5. ALCAYDE, JACKYLOU E. Jackylou, 25 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine March 15, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Monteverde, Bagumbayan, Sultan 2103-0264 40weeks age of gestation, Cephalic in Labor, delivered thru normal 3:00 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 October 1,
Birth weight =2,600 grams. 2024
6. MALON, AIZA A. Aiza, 30 y.o, Gravida 4 Parity 4(4-0-0-4) Pregnancy uterine 38 March 18, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Kapaya, Bagumbayan, Sultan 2103-0278 6/7weeks age of gestation, Cephalic in Labor, delivered thru normal 10:30 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat spontaneous vaginal delivery to an alive baby boy, Apgar Score = 8-9 0917-525-8870 0906-934-1969 October 1,
Birth weight=3,100 grams. 2024
7. RECORTE, EMAVY A. Emavy, 27 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 1/7 March 22, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Prk. Sampaguita, Sison, weeks age of gestation, Cephalic in Labor, delivered thru normal 5:00 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Bagumbaya, Sultan Kudarat 2103-0284 spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 October 1,
Birth weight = 2,800 grams. 2024
8. MAGNO, RELYN S. Relyn, 26 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 3/7 March 25, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Prk. Rose, Kabulanan, 2103-0298 weeks age of gestation, Cephalic in Labor, delivered thru normal 7:10 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Bagumbayan, Sulta Kudarat spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 October 1,
Birth weight = 3,000 grams. 2024
9. CUSTAN, ERICA JOY S. Erica joy, 21 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine March 28, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Monteverde, Bagumbayan, Sultan 2103-0312 40weeks age of gestation, Cephalic in Labor, delivered thru normal 12:51 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat spontaneous vaginal delivery to an alive baby boy, Apgar Score = 8-9 0917-525-8870 0906-934-1969 October 1,
Birth weight =3,200 grams. 2024
10. MASENDO, ROSALIE N. Rosalie, 29 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy uterine 39 April 1, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Biwang, Bagumbayan, Sultan 2104-0325 weeks age of gestation, Cephalic in Labor, Delivered thru normal 2:39 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat spontaneous vaginal delivery to an alive baby girl, Apgar Score = 8-9 0917-525-8870 0906-934-1969 2024
Birth weight =2,500 grams.
11. PAMA, BENETH F. Beneth, 30 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy April 4, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Pob. Bagumbayan, Sultan Kudarat 2104-0339 uterine 38weeks age of gestation, Cephalic in Labor, 4:41 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
delivered thru normal spontaneous vaginal delivery to an 0917-525-8870 0906-934-1969 October 1
alive baby boy, Apgar Score = 8/9 Birth weight =3,200 , 2024
grams.
12. GASCO, JORALDEN C. Joralden, 25 y.o, Gravida 3 Parity 3 (3-0-0-3) April 7, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Monteverde, Bagumbayan, Sultan 2104-0351 Pregnancy uterine 39 3/7 weeks age of gestation, 10:43 PM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat Cephalic in Labor, delivered thru normal spontaneous 0917-525-8870 0906-934-1969 October 1
vaginal delivery to an alive baby boy, Apgar Score = 8-9 , 2024
Birth weight =3,100 grams.
13. SANDIGAN, MONICA B. Monica, 20 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy May 15, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Nakan, Bagumbayan, Sultan 2105-0487 uterine 39 6/7 weeks age of gestation, Cephalic in 1:55 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat Labor, delivered thru normal spontaneous vaginal 0917-525-8870 0906-934-1969 October 1,
delivery to an alive baby boy, Apgar Score = 8-9 Birth 2024
weight = 2,600 grams.
14. MORENO, LOVELY L. Lovely, 30 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy May 19, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Titulok, Bagumbayan, Sultan 2105-0495 uterine39 4/7weeks age of gestation, Cephalic in Labor, 9:03 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Kudarat delivered thru normal spontaneous vaginal delivery to an 0917-525-8870 0906-934-1969 October 1,
alive baby girl, Apgar Score = 8-9 Birth weight =3,000 2024
grams.
15.NANAT,ROSALIE L. Rosalie, 23 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
Panama,Sumilil,Bagumba 0222 uterine 40 weeks age of gestation, Cephalic in Labor, March 6, 2022 Bagumbayan Sultan Kudarat Agduma Jr,II,RN,RM Instructor 0168790
Sultan Kudarat delivered thru normal spontaneous vaginal delivery to an 1:35pm 0917-525-8870 0926-173-4269 June 14, 2023
alive baby boy, Apgar Score = 8-9 Birth weight =3,000
grams.
16.BANSIL, RAHIMA K. Rahima, 29 y.o, Gravida 4 Parity 4 (4-0-0-4) April 1, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
Daguma, Bagumbayan, Sultan 0344 Pregnancy uterine 40 weeks age of gestation, Cephalic in 9:40 AM Bagumbayan Sultan Kudarat Agduma Jr, II, RN,RM Instructor 0168790
Kudarat Labor, delivered thru normal spontaneous vaginal 0917-525-8870 0926-173-4269 June 14, 2023
delivery to an alive baby boy, Apgar Score = 8-9 Birth
weight =3,200 grams.
17.MANSON, MECCA MAE M. Mecca Mae, 28 y.o, Gravida 4 Parity 4 (4-0-0-4) April 13, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
Sison, Bagumbayan, Sultan Kudarat 0382 Pregnancy uterine 40weeks age of gestation, Cephalic in 2:00 PM Bagumbayan Sultan Kudarat Agduma Jr, II, RN,RM Instructor 0168790
Labor, delivered thru normal spontaneous vaginal 0917-525-8870 0926-173-4269 June 14, 2023
delivery to an alive baby girl Apgar, Score = 8-9 Birth
weight = 2,500 grams.
18.SEGUARA, JUDY ANN B. Judy Ann, 27 y.o, Gravida 3 Parity 3 (3-0-0-3) April 19, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
Kabiyanan, Bagumbayan, Sultan 0405 Pregnancy uterine 40 3/7weeks age of gestation, 10:00 AM Bagumbayan Sultan Kudarat Agduma Jr, II, RN,RM Instructor 0168790
Kudarat Cephalic in Labor, delivered thru normal spontaneous 0917-525-8870 0926-173-4269 June 14, 2023
vaginal delivery to an alive baby girl, Apgar Score = 8/9
Birth weight = 2,900 grams
19.MAFIL, RUBY ANN B. Ruby, Ann, 20 y.o, Gravida 2 Parity 2 (2-0-0-2) April 24, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
San Vicente, Bai Saripinang, 0433 Pregnancy uterine 40weeks age of gestation, Cephalic in 3:07 AM Bagumbayan Sultan Kudarat Agduma Jr, II, RN,RM Instructor 0168790
Bagumbayan, Sultan Kudarat Labor, delivered thru normal spontaneous vaginal 0917-525-8870 0926-173-4269
June 14, 2023
delivery to an alive baby boy Apgar, Score = 8-9 Birth
weight = 3,000 grams.
20.AYSON, RUBY JEAN Ruby Jean, 26 y.o, Gravida 3 Parity 3 (3-0-0-3) April 29, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical
Sitio Maligaya, Bagumbayan, Sultan 0442 Pregnancy uterine 39 3/7 weeks age of gestation, 3:35 AM Bagumbayan Sultan Kudarat Agduma Jr, II, RN,RM Instructor 0168790
Kudarat Cephalic in Labor, delivered thru normal spontaneous 0917-525-8870 0926-173-4269 June 14, 2023
vaginal delivery to an alive baby girl, Apgar Score = 8-9
Birth weight =2,700 grams.
NOTE: Registered Midwives who supervise students must present certificate of training on Midwifery Practice as provided for under RA 7392

SUBSCRIBED AND SWORN TO BEFORE ME Certified Correct:

This, ______________________at__________________ Signature: Date:______
Affiant exhibiting to me his/her Name in Print: BONIFACIO E. VALDEZ, RM, RN, REB, MAN, MPM, MD, Ph.D
Residence Certificate no. _________________________ Designation: Dean, College of Midwifery
___________________Issued at ___________________ License No.: 0158098 Expiry Date: June 5, 2024_
___________________on ________________________
____________________________
Notary Public
 PROFESSIONAL REGULATION COMMISSION
MANILA
BOARD OF MIDWIFERY
RECORD OF ACTUAL INTERNAL EXAMINATION

Please check if applicant is:

___/___Graduate Midwife _______Registered Nurse
Name of Applicant: MOPAK, REBECCA DONDOK School: VMC ASIAN COLLEGE FOUNDATION, Tacurong City, SultanKudarat

Name and Date/Time Full Name, Address & Contact Printed Name of CI Position/ License No./
Address of Patient Case No. Complete Diagnosis Performed Number ofFacility and Contact Number Designation Signature Expiry Date
1. PIMENTEL, JENEVIE T. Jenevie, 22 y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 39 March 1, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Kanulay, Bagumbayan, Sultan 3/7weeks age of gestation, Cephalic Presentation, In active labor, with 8- 1:05 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
2102-0222
Kudarat 9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0906-934-1969 2024
water.
2. CAMPO, ROHANA M. Rohana, 25 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 39 March 5, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Nakan, Bagumbayan, Sultan 4/7weeks age of gestation, Cephalic Presentation, In active labor, with 7- 9:15 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
2103-0236
Kudarat 8cmcervical dilatation, 60-70% effacement, station +1and intact bag of 0917-525-8870 0906-934-1969 October 1,
water. 2024
3. BAUTISTA, CRYSTYL C. Crystyl, 27 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 40 weeks March 8, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Monteverde, Bagumbayan, Sultan 2103-0242 age of gestation, Cephalic Presentation, In active labor, with 8-9cmcervical 4:10 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat dilatation, 80-90% effacement, station +2and intact bag of water. 0917-525-8870 0906-934-1969 2024
4. KULAT, JULIET S. Juliet, 23 y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 39 5/7 weeks RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
March 11, 2021
Daguma, Bagumbayan, Sultan 2103-0252 age of gestation, Cephalic Presentation, In active labor, with8-9cmcervical Bagumbayan Sultan Kudarat RM Instructor October 1,
7:00 PM
Kudarat dilatation, 80-90% effacement, station +2and intact bag of water. 0917-525-8870 0906-934-1969 2024

5. ALCAYDE, JACKYLOU E. Jackylou, 25 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 40weeks March 15, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Monteverde, Bagumbayan, Sultan 2103-0264 age of gestation, Cephalic Presentation, In active labor, with 7-8cm cervical 12:05 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat dilatation,60-70% effacement, station +1and intact bag of water. 0917-525-8870 0906-934-1969 2024
6. MALON, AIZA A. Aiza, 30 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 38 6/7weeks March 18, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Kapaya, Bagumbayan, Sultan 2103-0278 age of gestation, Cephalic Presentation, In active labor, with 8-9cm cervical 7:15 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat dilatation, 80-90% effacement, station +2and intact bag of water. 0917-525-8870 0906-934-1969 2024
7. RECORTE, EMAVY A. Emavy, 27 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 39 1/7 March 22, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Prk. Sampaguita, Sison, weeks age of gestation, Cephalic Presentation, In active labor, with7- 2:00 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
2103-0284
Bagumbayan, Sultan Kudarat 8cmcervical dilatation, 60-70% effacement, station +1and intact bag of 0917-525-8870 0906-934-1969 October 1,
water. 2024
8. MAGNO, RELYN S. Relyn, 26 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 39 3/7 March 25, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical
Prk. Rose, Kabulanan, 2103-0298 weeks age of gestation, Cephalic Presentation, In active labor, with 8- 4:06 AM Bagumbayan Sultan Kudarat RM Instructor 0128197
Bagumbayan, Sulta Kudarat 9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0906-934-1969 October 1,
water. 2024

9. CUSTAN, ERICA JOY S. Erica joy, 21 y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 40weeks March 27, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Monteverde, Bagumbayan, Sultan 2103-0312 age of gestation, Cephalic Presentation, In active labor, with 8-9cmcervical 9:30 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat dilatation, 80-90% effacement, station +2and intact bag of water. 0917-525-8870 0906-934-1969 2024
10. MASENDO, ROSALIE N. Rosalie, 29 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 39 weeks April 1, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Biwang, Bagumbayan, Sultan 2103-0325 age of gestation, Cephalic Presentation, In active labor, with 7-8cmcervical 11:20 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat dilatation, 60-70% effacement, station +1and intact bag of water. 0917-525-8870 0906-934-1969 2024
11. PAMA, BENETH F. Beneth, 30 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 38weeks April 4, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Pob. Bagumbayan, Sultan Kudarat 2104-0339 age of gestation, Cephalic Presentation, In active labor, with 8-9cmcervical 1:20 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
dilatation, 80-90% effacement, station +2and intact bag of water. 0917-525-8870 0906-934-1969 2024
12. GASCO, JORALDEN C. Joralden, 25 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 April 7, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Monteverde, Bagumbayan, Sultan 2104-0351 3/7weeks age of gestation, Cephalic Presentation, In active labor, with 7- 7:16 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 8cmcervical dilatation, 70-80% effacement, station +1and intact bag of 0917-525-8870 0906-934-1969 2024
water
13. SANDIGAN, MONICA B. Monica, 20 y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 39 6/7 May 14, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Nakan, Bagumbayan, Sultan 2104-0487 weeks age of gestation, Cephalic Presentation, In active labor, with 8- 10:30 PM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0906-934-1969 2024
water.
14. MORENO, LOVELY L. Lovely, 30 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine39 May 19, 2021 RHU Bagumbayan Birthing Home Janette L. Dagol, RN, Clinical 0128197
Titulok, Bagumbayan, Sultan 2105-0495 4/7weeks age of gestation, Cephalic Presentation, In active labor, with 7- 6:09 AM Bagumbayan Sultan Kudarat RM Instructor October 1,
Kudarat 8cmcervical dilatation, 70-80% effacement, station +1and intact bag of 0917-525-8870 0906-934-1969 2024
water
15.NANAT,ROSALIE Rowaida, 22, y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 39 1/7 March 16, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
Panama,Sumilil,Bagumba weeks age of gestation, Cephalic Presentation, In active labor, with 8- 9:35AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
Sultan Kudarat 9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0926-173-4269
water.
16.BANSIL, RAHIMA K. Rahima, 29 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 40 weeks April 1, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
Daguma, Bagumbayan, Sultan 0344 age of gestation, Cephalic Presentation, In active labor, with 7-8cmcervical 6:20 AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
Kudarat dilatation, 70-80% effacement, station +1and intact bag of water 0917-525-8870 0926-173-4269
17.MANSON, MECCA MAE M. Mecca Mae, 28 y.o, Gravida 4 Parity 3 (4-0-0-3) Pregnancy uterine 40 April 13, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
Sison, Bagumbayan, Sultan Kudarat 0382 weeks age of gestation, Cephalic Presentation, In active labor, with 8- 11:00 AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0926-173-4269
water.
18.SEGUARA, JUDY ANN B. Judy Ann, 27 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 40 April 19, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
kabiyanan, Bagumbayan, Sultan 0405 3/7weeks age of gestation, Cephalic Presentation, In active labor, with 7- 7:00 AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
Kudarat 8cmcervical dilatation, 70-80% effacement, station +1and intact bag of 0917-525-8870 0926-173-4269
water
19.MAFIL, RUBY ANN B. Ruby, Ann, 20 y.o, Gravida 2 Parity 1 (2-0-0-1) Pregnancy uterine 40 April 24, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
San Vicente, Bai Saripinang, 0433 weeks age of gestation, Cephalic Presentation, In active labor, with 8- 12:16 AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
Bagumbayan, Sultan Kudarat 9cmcervical dilatation, 80-90% effacement, station +2and intact bag of 0917-525-8870 0926-173-4269
water.
20.AYSON, RUBY JEAN Ruby Jean, 26 y.o, Gravida 3 Parity 2 (3-0-0-2) Pregnancy uterine 39 3/7 April 29, 2022 RHU Bagumbayan Birthing Home Pualino Ryan S. Clinical 0168790
Sitio Maligaya, Bagumbayan, 0442 weeks age of gestation, Cephalic Presentation, In active labor, with 7- 12:30 AM Bagumbayan Sultan Kudarat Agduma Jr. II, RN,RM Instructor June14,2023
Sultan Kudarat 8cmcervical dilatation, 70-80% effacement, station +1and intact bag of 0917-525-8870 0926-173-4269
water.
NOTE: Registered Midwives who supervise students must present certificate of training on Midwifery Practice as provided for under RA 7392

SUBSCRIBED AND SWORN TO BEFORE ME Certified Correc:

This, ______________________at__________________ Signature: Date:______
Affiant exhibiting to me his/her Name in Print: BONIFACIO E. VALDEZ, RM, RN, REB, MAN, MPM, MD, Ph.D
Residence Certificate no. _________________________ Designation: Dean, College of Midwifery
___________________Issued at ___________________ License No.: 0158098 Expiry Date: June 5, 2024_
___________________on ________________________
____________________________
Notary Public
 PROFESSIONAL REGULATION COMMISSION
MANILA
BOARD OF MIDWIFERY
RECORD OF ACTUAL REPAIR OF PERINEAL LACERATION

Please check if applicant is:

___/___Graduate Midwife _______Registered Nurse
Name of Applicant: MOPAK, REBECCA DONDOK School: VMC ASIAN COLLEGE FOUNDATION, Tacurong City, SultanKudarat

Name and Date/Time Full Name, Address & Contact Printed Name of CI Position/ License No./
Address of Patient Case No. Complete Diagnosis Performed Number of Facility and Contact Number Designation Signature Expiry Date
1. SAMAMA, ELMA S. Elma, 22 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine 39 weeks October 14, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Datu Paglas, Maguindanao 2021-0280 age of gestation, Cephalic in Labor, delivered thru normal spontaneous 12:15 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
vaginal delivery to an alive babygirl, APGAR Score = 8/9 Birth weight = 0956-736-8198 2024
2,500 grams with 2nd degree perineal laceration, repair done.
2. TATUAN, RAHEMA A. Rahema, 28 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy uterine 39 1/7 October 19, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Pob. Buluan, Maguindanao weeks age of gestation, Cephalic in Labor, delivered thru normal 6:21 PM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
2021-0281 spontaneous vaginal delivery to an alive babygirl, APGAR Score = 8/9 0956-736-8198 2024
Birth weight = 2,600 grams with 2nd degree perineal laceration, repair done.

3. KADER, ARABIYA S. Arabiya, 25 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine 39weeks October 23, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Malangit, Pandag, Maguindanao 2021-0282 age of gestation, Cephalic in Labor, delivered thru normal spontaneous 7:16 PM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
vaginal delivery to an alive baby boy, APGAR Score = 8/9 Birth weight 0956-736-8198 2024
=3,200 grams with 2nd degree perineal laceration, repair done.
4. AGAL, WAHIDA S. Wahida, 26 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 2/7 November 1, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Popol, Buluan, Maguindanao 2021-0283 weeks age of gestation, Cephalic in Labor, delivered thru normal 4:20 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
spontaneous vaginal delivery to an alive baby girl, APGAR Score = 8/9 0956-736-8198 2024
Birth weight =2,600 grams with 2nd degree perineal laceration, repair done.
5. AGUINALDO, LINDA P. Linda, 30 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy uterine 39 4/7 November 6, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Katil, Datu Paglas, Maguindanao 2021-0284 weeks age of gestation, Cephalic in Labor, delivered thru normal 2:27 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
spontaneous vaginal delivery to an alive baby boy, APGAR Score = 8/9 0956-736-8198 2024
Birth weight =3,200 grams with 2nd degree perineal laceration, repair done.
NOTE: Registered Midwives who supervise students must present certificate of training on Midwifery Practice as provided for under RA 7392

SUBSCRIBED AND SWORN TO BEFORE ME Certified Correct:

This, ______________________at__________________ Signature: Date:______
Affiant exhibiting to me his/her Name in Print: BONIFACIO E. VALDEZ, RM, RN, REB, MAN, MPM, MD, Ph.D
Residence Certificate no. _________________________ Designation: Dean, College of Midwifery
___________________Issued at ___________________ License No.: 0158098 Expiry Date: June 5, 2024_
___________________on ________________________
____________________________
Notary Public

Affix
Documentary Stamp
 PROFESSIONAL REGULATION COMMISSION
MANILA
BOARD OF MIDWIFERY
RECORD OF ACTUAL INTRAVENOUS INSERTION / INFUSION

Please check if applicant is:

___/___Graduate Midwife _______Registered Nurse
Name of Applicant: MOPAK, REBECCA DONDOK School: VMC ASIAN COLLEGE FOUNDATION, Tacurong City, SultanKudarat

Name and Date/Time Full Name, Address & Contact Printed Name of CI Position/ License No./
Address of Patient Case No. Complete Diagnosis Performed Number of Facility and Contact Number Designation Signature Expiry Date
1. EDZA, HAIBA U. Haiba, 27 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 August 31, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Pob. Buluan, Maguindanao weeks age of gestation, Cephalic in Labor, delivered thru normal 1:00 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
2021-0275 spontaneous vaginal delivery to an alive baby boy, Birth weight = 0956-736-8198 2024
2,800 grams. Vagina Bleeding.
2. MONTANI, MUSARAPA S. Musarapa, 30 y.o, Gravida 4 Parity 4 (4-0-0-4) Pregnancy uterine September 4, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Pob. Datu Paglas, Maguindanao 39 2/7 weeks age of gestation,Cephalic in Labor, delivered thru 6:40 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
2021-0276 normal spontaneous vaginal delivery to an alive baby girl, Birth 0956-736-8198 2024
weight = 2,500 grams , Vagina Bleeding.
3. MANAMBUAY, HERIYA K. Heriya, 28 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 39 September 10, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Pob. Buluan, Maguindanao 6/7 weeks age of gestation, Cephalic in Labor, delivered thru normal 9:30 PM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
2021-0277 spontaneous vaginal delivery to an alive baby girl,Birth weight = 0956-736-8198 2024
2,900 grams , Vagina Bleeding .
4. PINGOT, AYPA M. Aypa, 23 y.o, Gravida 2 Parity 2 (2-0-0-2) Pregnancy uterine 391/7 September 12, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
DavaoCity 2021-0278 weeks age of gestation, Cephalic in Labor, delivered thru normal 7:50 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
spontaneous vaginal delivery to an alive baby girl, Birth weight 0956-736-8198 2024
=2,800 grams, Vagina Bleeding.

5. BACASA, ASMA S. Asma, 29 y.o, Gravida 3 Parity 3 (3-0-0-3) Pregnancy uterine 38 October 12, 2021 Well-Family Midwife Clinic Delia B. Valdez, RM Clinical 0049809
Digal, Buluan, Maguindanao 2021-0279 2/7weeks age of gestation, Cephalic in Labor, delivered thru normal 2:55 AM Pob. Datu Paglas, Maguindanao 0935-870-9446 Instructor December 14,
spontaneous vaginal delivery to an alive baby boy, Birth weight 0956-736-8198 2024
=3,000 grams ., Vagina Bleeding.
NOTE: Registered Midwives who supervise students must present certificate of training on Midwifery Practice as provided for under RA 7392

SUBSCRIBED AND SWORN TO BEFORE ME Certified Correct:

This, ______________________at__________________ Signature: Date:______
Affiant exhibiting to me his/her Name in Print: BONIFACIO E. VALDEZ, RM, RN, REB, MAN, MPM, MD, Ph.D
Residence Certificate no. _________________________ Designation: Dean, College of Midwifery
___________________Issued at ___________________ License No.: 0158098 Expiry Date: June 5, 2024_
___________________on ________________________
____________________________
Notary Public

Affix
Documentary Stamp