St.
Rita Hospital College of Nursing and Midwifery 2047 T Earnshaw Street Gagalangin Tondo Manila
Prepared by: NAME of STUDENT: ELIZON, ARIANE FAITH C. Accreditation Level: (if any) Date School/ Program was Recognized: BSN July 2, 1992 First Course: (if any ) Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): 2012 Date of operation
September 14, 2011
. Number: C 030 2005 I. MAJOR OPERATION . Year Granted: Series: 1992 School Graduated From: Year: July 2, 1992 Year: . . . . . Type of Anesthesia
Subarachnoid Block Subarachnoid Block/ Continuous Lumbar Epidural Anesthesia/ General Endotracheal Anesthesia
Case No
082640
Name of Patient
R. Z.
Diagnosis
Recurrent direct inguinal right
Operation Performed
Mesh Herniorrhaphy Right
Name of Surgeon
Dr. Min F. Fernandez
Name of Hospital
Tondo Medical Center
Name of O.R. Scrub Nurse
Lourdes L. Bonifacio RN, MAN
Supervised by: Name and Signature of Qualified C.I.
Carmen B. Estigoy RN, MAN
September 16, 2011
011739
M. J.
Gravida 2 Para 2 (1001) Pregnancy Uterine 38 1/7 weeks Age of Gestation cephalic in labor previous low transverse cesarean section secondary to breech
Low Transverse Cesarean Section
Dr. Jillian Marie G. Diaz
Tondo Medical Center
Larena V. Hernandez RN, MAN
Lourdes L. Bonifacio RN, MAN
September 19, 2011
379049
C. V.
Gravida 2 Para 1 (1001) Pregnancy Uterine 42 5/7 weeks Age of Gestation, cephalic in labor previous cesarean section 1 secondary to unknown indication.
Low Transverse Cesarean Section
Subarachnoid Block
Dr. Jay-Lanie D. Co
Tondo Medical Center
Larena V. Hernandez RN, MAN
Carmen B. Estigoy RN, MAN
September 20, 2011
047866
E. D.
Perforated Peptic Ulcer 1cm.
Exploratory Laparotomy, Gastrorrhaphy, Omental Patching, Placement of drain Total Lobectomy Right Isthmusectomy Subtotal Lobectomy Left
General Endotracheal Anesthesia General Endotracheal Anesthesia
Dr. Min F. Fernandez
Tondo Medical Center
Maria Teresa M. Fraga RN, MAN, Ed.D Lourdes L. Bonifacio RN, MAN
Carmen B. Estigoy RN, MAN
September 21, 2011
155429
B. M.
Colloid Adenomatus Goiter Right
Dr. Min F. Fernandez
Tondo Medical Center
Carmen B. Estigoy RN, MAN
Concurred by: RHODORA A. QUILANTIP, RN., MAN. . Signature over printed Name of Chief Nurse Date Signed: Degree: M.A.N.
Approved by: MARIA CLAUDIA A. MARQUEZ, RN. MAN. Signature over printed Name of Dean Date Signed: Degree: M.A.N. a.) PRC NO.: Valid Until: 0149796 April 2, 2014 b.) PNA NO.:
Noted by: CARMEN B ESTIGOY, RN. MAN Signature over printed Name of Clinical Instructor Date Signed: . Degree: M.A.N. . a.) PRC NO.: Valid Until: 17905 . Valid Until: 0067396 July 28, 2014 . . . .
a.)
PRC NO.: 0097511 Valid Until: July 8, 2012
b.)
PNA NO.: 18651 Valid Until: Life time Member
b.) PNA NO.: 8435 Valid Until: Lifetime Member c.) ADCPN NO.: 429
Life time Member
Valid Until:
December. 31, 2012
St. Rita Hospital College of Nursing and Midwifery 2047 T Earnshaw Street Gagalangin Tondo Manila
Prepared by: NAME of STUDENT: ELIZON, ARIANE FAITH C. Accreditation Level: (if any) Date School/ Program was Recognized: BSN July 2, 1992 First Course: (if any ) Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program): Date of operation February 08, 2011 Name of Patient B. E.
. Number: C 030 2005 2012 II. MINOR OPERATION Type of Anesthesia Local Anesthesia . Year Granted: Series: 1992 School Graduated From: Year: July 2, 1992 Year: . . . . . Supervised by: Name and Signature of Qualified C.I. Hermina M. Protacio RN, MAN
Case No
Diagnosis
Operation Performed
Name of Surgeon Dr. Darwin U. Oandasan
Name of Hospital Tondo Medical Center
Name of O.R. Scrub Nurse
552871
Tendon Cyst Wrist Right
Excision of Tendon Cyst
Alicia F. Barrientos RN.
March 07, 2011
352518
J. G.
Incomplete Abortion Pregnancy Uterine 13-14 weeks Age of Gestation Gravida 2 Para 1 Incomplete Abortion Pregnancy Uterine 13 weeks Age of Gestation Gravida 2 Para 1 Lipoma at Clavicular Area
Completion Curettage
Intravenous Sedation
Dr. Marietess F. Ramos
Tondo Medical Center
Virginia A. Flores RN.
Donna Lynne T. Lopez RN, MAN
March 08, 2011 August 24, 2011 August 25, 2011
358610
L. R.
Completion Curettage
Intravenous Sedation
Dr. Jillian Marie G. Diaz Dr. Solna Minerva A. Decena Dr. Reynaldo Puig
Tondo Medical Center Tondo Medical Center Tondo Medical Center
Jane R. De Jesus RN, MAN
Donna Lynne T. Lopez RN, MAN Ricardo M. Binuya RN, MAN Ricardo M. Binuya RN, MAN
336571
V. E
Excision of Lipoma
Local Anesthesia
Alicia F. Barrientos RN.
372798
A. T.
Breast Mass at Right
Lumpectomy
Local Anesthesia
Alicia F. Barrientos RN.
Concurred by: RHODORA A. QUILANTIP, RN., MAN. . Signature over printed Name of Chief Nurse Date Signed: Degree: M.A.N.
Approved by: MARIA CLAUDIA A. MARQUEZ, RN. MAN. Signature over printed Name of Dean Date Signed: Degree: M.A.N. a.) PRC NO.: Valid Until: 0149796 April 2, 2014 b.) PNA NO.:
Noted by: CARMEN B ESTIGOY, RN. MAN Signature over printed Name of Clinical Instructor Date Signed: . Degree: M.A.N. . a.) PRC NO.: Valid Until: 17905 . Valid Until: 0067396 July 28, 2014 . . . .
a.) b.)
PRC NO.: Valid Until: PNA NO.: Valid Until:
0097511 July 8, 2012 18651 Life time Member
b.) PNA NO.: 8435 Valid Until: Lifetime Member c.) ADCPN NO.: 429
Life time Member
Valid Until:
December. 31, 2012
St. Rita Hospital College of Nursing and Midwifery 2047 T Earnshaw Street Gagalangin Tondo Manila
Prepared by: NAME of STUDENT: ELIZON, ARIANE FAITH C. Accreditation Level: (if any) Date School/ Program was Recognized: BSN July 2, 1992 First Course: (if any ) Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program):
. Number: C 030 2005 2012 III. DELIVERIES HANDLED . Year Granted: Series: 1992 School Graduated From: Year: July 2, 1992 Year: . . . . .
No
Case No.
Diagnosis Pregnancy Uterine 38 weeks Age of Gestation Gravida 3 Para 3 Pregnancy Uterine 40 weeks Age of Gestation Gravida 1 Para 1 Pregnancy Uterine 38 weeks Age of Gestation Gravida 2 Para 2 Pregnancy Uterine 38 weeks Age of Gestation Gravida 1 Para 1 Pregnancy Uterine 38 weeks Age of Gestation Gravida 3 Para 3
Name of Mother R. C.
Age
Date of Delivery
Time of Delivery 09:50 am
Gender of Baby Male
Name of Hospital
Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
Supervised by: Name and Signature of Qualified C.I. Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN
358860
34
March 09, 2011
Tondo Medical Center
373378
L. L
23
August 02, 2011
12:10pm
Female
Tondo Medical Center
354621
A. T.
26
August 03, 2011
09:55 am
Male
Tondo Medical Center
360850
C. F.
26
August 08, 2011
11:54 am
Male
Tondo Medical Center
355586
V. G.
24
August 10, 2011
09:38 am
Male
Tondo Medical Center
Concurred by: RHODORA A. QUILANTIP, RN., MAN. . Signature over printed Name of Chief Nurse Date Signed: Degree: M.A.N.
Approved by: MARIA CLAUDIA A. MARQUEZ, RN. MAN. Signature over printed Name of Dean Date Signed: Degree: M.A.N. a.) PRC NO.: Valid Until: b.) PNA NO.: Valid Until: 0149796 April 2, 2014 8435 Lifetime Member b.) PNA NO.:
Noted by: CARMEN B ESTIGOY, RN. MAN Signature over printed Name of Clinical Instructor Date Signed: . Degree: M.A.N. . a.) PRC NO.: Valid Until: 17905 . Valid Until: 0067396 July 28, 2014 . . . .
a.) b.)
PRC NO.: Valid Until: PNA NO.: Valid Until:
0097511 July 8, 2012 18651 Life time Member
Life time Member
c.) ADCPN NO.: 429 Valid Until: December. 31, 2012
St. Rita Hospital College of Nursing and Midwifery 2047 T Earnshaw Street Gagalangin Tondo Manila
Prepared by: NAME of STUDENT: ELIZON, ARIANE FAITH C. Accreditation Level: (if any) Date School/ Program was Recognized: BSN July 2, 1992 First Course: (if any ) Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program):
. Number: C 030 2005 2012 IV. DELIVERIES ASSISSTED . Year Granted: Series: 1992 School Graduated From: Year: July 2, 1992 Year: . . . . .
No
Case No.
Diagnosis Pregnancy Uterine 39 weeks age of gestation Gravida 1 Para 1 Pregnancy Uterine 41 weeks Age of Gestation Gravida 5 Para 3 Pregnancy Uterine 41 weeks Age of Gestation Gravida 1 Para 1 Pregnancy Uterine 38 weeks Age of Gestation Gravida 1 Para 1 Pregnancy Uterine 40 weeks Age of Gestation Gravida 1 Para 1
Name of Mother
Age
Date of Delivery
Time of Delivery
Gender of Baby Male
Name of Hospital
Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
Noted by:
Supervised by: Name and Signature of Qualified C.I. Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN
354519
M. Z.
37
March 09, 2011
11:45 am
Tondo Medical Center
336873
J. B.
31
August 01, 2011
11:00 am
Female
Tondo Medical Center
373015
M. M.
20
August 09, 2011
10:52 am
Male
Tondo Medical Center
365028
R. E.
16
August 10, 2011
07:52 am
Male
Tondo Medical Center
355263
M. M.
32
August 10, 2011
10:45 am
Female
Tondo Medical Center
Concurred by: RHODORA A. QUILANTIP, RN., MAN. . Signature over printed Name of Chief Nurse Date Signed: Degree: M.A.N.
Approved by: MARIA CLAUDIA A. MARQUEZ, RN. MAN. Signature over printed Name of Dean Date Signed: Degree: M.A.N. a.) PRC NO.: Valid Until: 0149796 April 2, 2014 8435 b.) PNA NO.:
CARMEN B ESTIGOY, RN. MAN Signature over printed Name of Clinical Instructor Date Signed: . Degree: M.A.N. . a.) PRC NO.: Valid Until: 17905 . 0067396 July 28, 2014 . .
a.) b.)
PRC NO.: Valid Until: PNA NO.:
0097511 July 8, 2012 18651
b.) PNA NO.:
Valid Until:
Life time Member
Valid Until: Lifetime Member c.) ADCPN NO.: 429 Valid Until: December. 31, 2012
Valid Until:
Life time Member
St. Rita Hospital College of Nursing and Midwifery 2047 T Earnshaw Street Gagalangin Tondo Manila
Prepared by: NAME of STUDENT: ELIZON, ARIANE FAITH C. Accreditation Level: (if any) Date School/ Program was Recognized: BSN July 2, 1992 First Course: (if any ) Year of Admission in the Bachelor of Science in Nursing Program: Year Graduated (BSN Program):
. Number: C 030 2005 2012 V. CORD DRESSING . Year Granted: Series: 1992 School Graduated From: Year: July 2, 1992 Year: . . . . .
No
Case No.
Date of Delivery
Name of Baby
Gender of Baby
Name of Mother
Age
Name of Hospital
Supervised by: Name and Signature of Qualified C.I. Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN Donna Lynne T. Lopez RN, MAN
Noted by: CARMEN B ESTIGOY, RN. MAN Signature over printed Name of Clinical Instructor Date Signed: . Degree: M.A.N. . a.) PRC NO.: Valid Until: 0067396 July 28, 2014 . . . .
1 2 3 4 5
362070 361583 373469 374099 140513
August 01, 2011 August 01, 2011 August 03, 2011 August 09, 2011 August 09, 2011
Baby girl Baby girl Baby girl Baby girl Baby boy
Female Female Female Female Male
M. R. M. R. A. C. M. A. R. P.
Newborn Newborn Newborn Newborn Newborn
Tondo Medical Center Tondo Medical Center Tondo Medical Center Tondo Medical Center Tondo Medical Center
Concurred by: RHODORA A. QUILANTIP, RN., MAN. . Signature over printed Name of Chief Nurse Date Signed: Degree: M.A.N.
Approved by: MARIA CLAUDIA A. MARQUEZ, RN. MAN. Signature over printed Name of Dean Date Signed: Degree: M.A.N. a.) PRC NO.: Valid Until: 0149796 April 2, 2014 b.) PNA NO.:
a.) b.)
PRC NO.: Valid Until: PNA NO.: Valid Until:
0097511 July 8, 2012 18651 Life time Member
b.) PNA NO.: 8435 Valid Until: Lifetime Member c.) ADCPN NO.: 429
17905
. Valid Until:
Life time Member
Valid Until:
December. 31, 2012
