prc form for nursing students planning to take the philippine nurse's licensure examination ...
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PRC Form for Nursing students planning to take the Philippine Nurse's Licensure ExaminationUniversity of Bohol, College of Nursing, Tagbilaran CityTRANSCRIPT
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
SURGICAL MAJOR in GOVERNOR CELESTINO GALLARES MEMORIAL HOSPITAL- TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed and Time Started
Patient’s INITIALSSURGICAL PROCEDURE
PERFORMED O.R. Nurse on DutySUPERVISED BY
CLINICAL INSTRUCTORCase Number
June 25, 20097:23 pm 072679 - JJAS
Exploratory Laparotomy, Adhesiolysis, Appendectomy,
Lavage PURIFICACION L. PIQUERO, BSN-RN LALAINE L. DOMAPIAS, BSN-RN, MAN
April 29, 20104:22 pm
101987-2010 - AASEmergency Repeat Cesarian Section with Bilateral Tubal
Ligation KARENE MARIE B. CALUNOD, BSN-RN ROSSINI C. BIRAD, BSN-RN, MAN
June 18, 20105:41 pm
121657-2010 - FCA Shortening Osteotomy Right Ulna ELIZABETH R. REYES, BSN-RN ROSSINI C. BIRAD, BSN-RN, MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MANClinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: _________________ Time: ____________ Date document is signed: _____________ Time: ___________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 2A
O.R. SCRUB FORM
Major
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
SURGICAL MAJOR in RAMIRO COMMUNITY HOSPITAL - TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed and Time Started
Patient’s INITIALSSURGICAL PROCEDURE PERFORMED O.R. Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
July 23, 20098:30 am
09-5021 - AAR Total Abdominal Hysterectomy with Bilateral Salpingo Oophorectomy with
AppendectomyLEONIDO A. FUNCHICA III, BSN-RN MAIA KRISTINE G. MARGATE,BSN –RN
May 13, 20109:50 pm
10-3426 - ALM Debridement, Open Reduction Cerclage Wiring Right Proximal Femur JUDEE D. BAGUIO, BSN- RN ROSETTE M. GARCIA, BSN-RN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MANClinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9, 2013 Dean, PRC I.D No. . 0131064 Valid Until November 16, 2012Date document is signed: _________________ Time: _____________ Date document is signed:________________ Time: ______________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 2A
O.R. SCRUB FORM
Major
University of BoholC O L L E G E O F N U R S I N G
City of TagbilaranMa. Clara St., Tagbilaran City
Bohol, PhilippinesPhone No.: (038) 411-3484/ Fax No.: (038) 411-3101
(Government Recognition No. 60, s. 1980)
SURGICAL MINOR in GOVERNOR CELESTINO GALLARES MEMORIAL HOSPITAL- TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed and Time Started
Patient’s INITIALS SURGICAL PROCEDURE PERFORMED O.R. Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTORCase Number
November 13, 20083:52 pm 4870 - DLC Removal of Toe Nails EVELYN C. MICABALO, BSN-RN ZENAIDA R. BUENCONSEJO, BSN-RN, MAN
September 3, 20091: 48 am 078230 - RMB Suturing HECTOR C. RODRIGUEZ, BSN-RN, MAN FLORDELIZA J. LUMANTAS, BSN –RN, MAN
December 17, 20092:08 pm
92378-2009 - IDPSuturing JOSEPH R. REDULLA, BSN-RN ELEAZAR D. LANZADERAS, BSN-RN
June 17, 20109: 30 pm
121861-2010 - ETO Emergency Repair of Corneal Laceration (Left Eye) MARIA NADINE A. LAGURA, BSN-RN ROSSINI C. BIRAD, BSN-RN, MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Coordinator, PRC I.D No.: 0066642 Valid Until : April 9, 2013 Dean, PRC I.D No. . 0131064 Valid Until November 16, 2012Date document is signed: ___________________ Time: ____________ Date document is signed: ___________________ Time: _____________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 2B
O.R. SCRUB FORM
Minor
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
SURGICAL MINOR in RAMIRO COMMUNITY HOSPITAL - TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed and Time Started
Patient’s INITIALS SURGICAL PROCEDURE PERFORMED O.R. Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
May 13, 2010
6:48 pm
10-3411 - PBG Arterio- Venous Shunt Insertion Right ALONA B. ARSENA, BSN-RN ROSETTE M. GARCIA, BSN-RN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Coordinator, PRC I.D No.: 0066642 Valid Until : April 9, 2013 Dean, PRC I.D No. . 0131064 Valid Until November 16, 2012Date document is signed: ___________________ Time: ____________ Date document is signed: ___________________ Time: _____________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 2B
O.R. SCRUB FORM
Minor
University of BoholC O L L E G E O F N U R S I N G
City of TagbilaranMa. Clara St., Tagbilaran City
Bohol, PhilippinesPhone No.: (038) 411-3484/ Fax No.: (038) 411-3101
(Government Recognition No. 60, s. 1980)
ASSISTED DELIVERY in GOVERNOR CELESTINO GALLARES MEMORIAL HOSPITAL- TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Delivered
Patient’s INITIALSPROCEDUREPERFORMED Nurse on Duty SUPERVISED BY
CLINICAL INSTRUCTORCase Number
October 15, 20092:15 pm 82697-2009 - MHC Assisted Delivery CERLITA D. BALO, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
October 17, 2009
3:47 pm82811-2009 - JOL Assisted Delivery FLORA S. MANIGQUE, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
April 8, 2010
8:12 pm110177-2010 - LBG Assisted Delivery ARLENE A. BONGCAYO, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
January 28, 201111:32 am
155658-2010 - GTG Assisted Delivery MARCELA P. PARAISO, BSN-RN MELINDA C. PAUSANOS,BSN-RN,MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9, 2013 Dean, PRC I.D No. . 0131064 Valid Until November 16, 2012Date document is signed: ________________ Time : ____________ Date document is signed: ________________ Time : ___________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1B
ASSISTED DELIVERY
FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
ACTUAL DELIVERY in GOVERNOR CELESTINO GALLARES MEMORIAL HOSPITAL- TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALS PROCEDUREPERFORMED Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
October 16, 20094:11 am
82784-2009 - LSA Handled DeliveryCORA G. GARAY, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
October 23, 2009
9:56 am83967-2009 - BOB Handled Delivery CERLITA D. BALO, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ___________________ Time: _____________ Date document is signed: _________________ Time: _______________ Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1A
ACTUAL DELIVERY
FORM
University of BoholC O L L E G E O F N U R S I N G
City of TagbilaranMa. Clara St., Tagbilaran City
Bohol, PhilippinesPhone No.: (038) 411-3484/ Fax No.: (038) 411-3101
(Government Recognition No. 60, s. 1980)
IMMEDIATE NEWBORN CORD CARE in GOVERNOR CELESTINO GALLARES MEMORIAL HOSPITAL- TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Delivered
Patient’s INITIALSCORD CARE Nurse on Duty SUPERVISED BY
CLINICAL INSTRUCTORCase Number
October 16, 20096:23 am
82786-2009 - JPB Delivery Room CORA G. GARAY, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
October 22, 20096:21 am
83776-2009 - JAT Delivery Room MARCELA P. PARAISO, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
April 8, 201011:36 pm
110177-2010 - CAC Delivery Room ARLENE A. BONGCAYO, BSN-RN VERLITA T. CUADRA,BSN-RN,MAN, PhD
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9, 2013 Dean, PRC I.D No. . 0131064 Valid Until November 16, 2012Date document is signed: ________________ Time : ____________ Date document is signed: ________________ Time : ___________Please specify Highest Nursing Degree Earned: BSN,MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1C
CORD CARE
FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
ACTUAL DELIVERY in RAMIRO COMMUNITY HOSPITAL - TAGBILARAN CITY, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALS PROCEDUREPERFORMED Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
May 15, 201012:03 am 10-3668 - SCP Handled Delivery ALONA B. ARSENA, BSN-RN ROSETTE M. GARCIA, BSN-RN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ____________________ Time: ______________ Date document is signed: __________________ Time: ________________Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1A
ACTUAL DELIVERY FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
ACTUAL DELIVERY in INTEGRATED MIDWIVES ASSOCIATION OF THE PHILPPINES LYING-IN, TAGBILARAN CITY, BOHOL Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALS PROCEDUREPERFORMED Midwife on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
May 6, 20102:27 pm
2264 - GGC Handled Delivery CORAZON L. PARAS, RM IVY L. CALCABEN, BSN-RN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ____________________ Time: ______________ Date document is signed: __________________ Time: ________________Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1A
ACTUAL DELIVERY FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
ACTUAL DELIVERY in CONGRESSMAN SIMEON TORIBIO MEMORIAL HOSPITAL- CARMEN, BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALS PROCEDUREPERFORMED Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
January 7, 20105:47 am 64885 - MCI Handled Delivery RICARDA P. MEBRANO, BSN-RN EMMA RUBY D. GOYENECHE, BSN-RN, MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ____________________ Time: ______________ Date document is signed: __________________ Time: ________________Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1A
ACTUAL DELIVERY
FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
IMMEDIATE NEWBORN CORD CARE in TEODORO B. GALAGAR DISTRICT HOSPITAL-JAGNA BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALSCORD CARE Nurse on Duty SUPERVISED BY
CLINICAL INSTRUCTORCase Number
August 28, 20101:55 am
068683 - JAS Delivery Room AGUSTINA B. BAYOCOT, BSN-RN LOIS JOAN S. NAMOCATCAT, BSN-RN, MAN
September 4, 20102:37 am
068822 - JDN Delivery RoomAGUSTINA B. BAYOCOT, BSN-RN LOIS JOAN S. NAMOCATCAT, BSN-RN, MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ____________________ Time: ______________ Date document is signed: __________________ Time: ________________Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1C
CORD CARE
FORM
University of BoholC O L L E G E O F N U R S I N G
City of Tagbilaran
Ma. Clara St., Tagbilaran CityBohol, Philippines
Phone No.: (038) 411-3484/ Fax No.: (038) 411-3101(Government Recognition No. 60, s. 1980)
ASSISTED DELIVERY in MANSASA BARANGAY HEALTH CENTER, TAGBILARAN CITY ,BOHOL
Prepared by:
MARK JOHNUEL M. DUAVIS
Date Performed andTime Started
Patient’s INITIALS PROCEDUREPERFORMED Nurse on Duty
SUPERVISED BYCLINICAL INSTRUCTOR
Case Number
August 28, 201010:08 am 0010 - GMG Assisted Delivery ERLINDA S. BOJO, BSN-RN MA. CONSUELO C. FORMILLEZA, BSN-RN, MAN
Noted by: CASILDA C. LAPEZ, BSN-RN, MAN Approved by: ISABELITA G. MARGATE, BSN-RN, MAN Clinical Coordinator, PRC I.D No.: 0066642 Valid Until: April 9,2013 Dean, PRC I.D No. 0131064 Valid Until November 16, 2012Date document is signed: ____________________ Time: ______________ Date document is signed: __________________ Time: ________________Please specify Highest Nursing Degree Earned: BSN, MAN Please specify Highest Nursing Degree Earned: BSN,MAN
ODC Form 1B
ASSISTED DELIVERY
FORM
