ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Major) in ______JOSE R. REYES MEMORIAL MEDICAL CENTER, STA.CRUZ MANILA, METRO MANILA_____ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student _______CHARIZE C. SANTIAGO_______

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number

SURGICAL PROCEDUREPERFORMED

O.R. Nurse On Duty(Name and Signature)

SUPERVISED BYClinical instructor

Name and Signature

September 8, 20119:20 a.m

A.O.D665171

Herniotomy of Left testes Grace A. Adaiao, RN Julita M. Talinio, RN MAN

September 7, 20111:25 p.m

A.W.C652134

T12 L3 Laminectomy Patrick T. Santiago, RN Julita M. Talinio, RN MAN

September 7, 20119:15 a.m

V.P.V668170

Exlaparotomy subtotal colectomy Dennis C. Valmores, RN Julita M. Talinio, RN MAN

September 1, 20117:30 a.m

A.G.P645372

Total Abdominal Hysterectomy Bilateral Salphingo Oophorectomy

Cristy V. Donquines, RN Julita M. Talinio, RN MAN

August 31, 20118:10 a.m

R.G.E648226

Modified Radical Mastectomy Grace A. Adaiao, RN Julita M. Talinio, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Minor) in _________RIZAL PROVINCIAL HOSPITAL, MORONG, RIZAL________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student ________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number

SURGICAL PROCEDUREPERFORMED

O.R. Nurse On Duty(Name and Signature)

SUPERVISED BYClinical instructor

Name and Signature

July 7, 20118:45 p.m

J.S.R456

Episiorraphy Aileen M. Villones, RM Rosemarie M. Sasaki, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MAN Clinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Minor) in _________MISSION HOSPITAL, PASIG CITY, METRO MANILA_______ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student ________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number

SURGICAL PROCEDUREPERFORMED

O.R. Nurse On Duty(Name and Signature)

SUPERVISED BYClinical instructor

Name and Signature

July 29, 20116:30 p.m

V.C.S834624

Wound suturing of Left middle finger

Kristian Noel T. Reyes, RN Earl Don B. De Castro, MD RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Minor) in _________JOSE R. REYES MEMORIAL MEDICAL CENTER, STA.CRUZ MANILA, METRO MANILA________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student ________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number

SURGICAL PROCEDUREPERFORMED

O.R. Nurse On Duty(Name and Signature)

SUPERVISED BYClinical instructor

Name and Signature

September 8, 201112:45 p.m

H.T.V660372

Debridement of Right Leg Lorraine Claire P. Danipog, RN Julita M. Talinio, RN MAN

August 31, 201112:30 p.m

F.R.B656228

Trans Urethral Resection of Prostate

Edgardo L. Dulatas, RN Julita M. Talinio, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Minor) in _________QUIRINO MEMORIAL MEDICAL CENTER, ANONAS QUEZON CITY, METRO MANILA________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student ________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number

SURGICAL PROCEDUREPERFORMED

O.R. Nurse On Duty(Name and Signature)

SUPERVISED BYClinical instructor

Name and Signature

October 24, 201110:05 a.m

J.P.C76198

Wound Debridement of Left Leg Richard L. Leonor, RN Marpaul M. Marica, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in__________MAUWAY LYING-IN CLINIC, MANDALUYONG CITY, METRO MANILA_________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __________CHARIZE C. SANTIAGO__________

Date Performedand

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

PROCEDUREPERFORMED

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

(If Midwife on Duty, Signature Not Required)

SUPERVISED BYClinical instructor

Name and Signature

April 27, 201112:53 p.m

J.G.V Normal Spontaneous Delivery Liezl B. Saluna, RM Mariflor N. Gariguez, RN MAN

April 26, 20117: 26 a.m

S.C.S Normal Spontaneous Delivery Zenaida A. Ricafranca, RM Mariflor N. Gariguez, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in__________RIZAL PROVINCIAL HOSPITAL, MORONG, RIZAL__________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __________CHARIZE C. SANTIAGO__________

Date Performedand

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

PROCEDUREPERFORMED

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

(If Midwife on Duty, Signature Not Required)

SUPERVISED BYClinical instructor

Name and Signature

July 13, 20114: 10 p.m

R.D.V454

Normal Spontaneous Delivery Nelita Nilda A. Cenidoza, RM Rosemarie M. Sasaki, RN MAN

July 6,20117: 48 p.m

J.G.F212

Normal Spontaneous Delivery Rowena D. Eslava, RM Rosemarie M. Sasaki, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in__________WELL-FAMILY CLINIC CATTLEYA, PEMBO, MAKATI CITY, METRO MANILA__________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __________CHARIZE C. SANTIAGO__________

Date Performedand

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

PROCEDUREPERFORMED

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

(If Midwife on Duty, Signature Not Required)

SUPERVISED BYClinical instructor

Name and Signature

August 11, 20113: 53 p.m

J.M.P Normal Spontaneous Delivery Caroliona E. Milan, RM April M. Moreno, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in ___________RIZAL PROVICIAL HOSPITAL, MORONG, RIZAL_________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by:

Printed Name and Signature of Student _________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

PROCEDUREPERFORMED

ASSISTED DELIVERY

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

(If Midwife on Duty, Signature Not Required)

SUPERVISED BYClinical instructor

Name and Signature

July 7, 2011 3:50 p.m

S.D.S239

Normal Spontaneous Delivery Aileen M. Villones, RM Rosemarie M. Sasaki, RN MAN

July 6, 20119:10 p.m

S.J.Q208

Normal Spontaneous Delivery Rowena D. Eslava, RM Rosemarie M. Sasaki, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in ___________TAGUIG PATEROS DISTRICT HOSPITAL, TAGUIG CITY, METRO MANILA ________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by:

Printed Name and Signature of Student _________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

PROCEDUREPERFORMED

ASSISTED DELIVERY

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

(If Midwife on Duty, Signature Not Required)

SUPERVISED BYClinical instructor

Name and Signature

October 27, 20118:02 p.m

A.H.D11-02966

Normal Spontaneous Delivery Marilyn T. Villadolid, RM Archimedes G. Balinas, RN RM MSN

October 26, 2011 2:52 p.m

C.G.B11-02956

Normal Spontaneous Delivery Vinamar Rafael M. Novejas, RM Archimedes G. Balinas, RN RM MSN

October 25, 20112:30 p.m

L.B.F11-02947

Normal Spontaneous Delivery Marilyn T. Villadolid, RM Archimedes G. Balinas, RN RM MSN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

IMMEDIATE NEWBORN CORD CARE in __________MAUWAY LYING-IN CLINIC, MANDALUYONG CITY, METRO MANILA_________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by:

Printed Name and Signature of Student _________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

Immediate Newborn Cord Care

PERFORMEDIndicate where performed e.g. D.R.,

Nursery, NICU, or Home

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

(If Midwife on Duty, Signature Not Required)SUPERVISED BY

Clinical instructorName and Signature

April 29, 20119:45 p.m

Baby Boy B. Delivery room Liezl B. Saluna, RM Mariflor N. Gariguez, RN MAN

April 25, 20116:15 p.m

Baby Boy C. Delivery room Zenaida A. Ricafranca, RM Mariflor N. Gariguez, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN

ARELLANO UNIVERSITYCOLLEGE of NURSING

2600 Legarda St., Sampaloc, Manila7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

IMMEDIATE NEWBORN CORD CARE in __________RIZAL PROVINCIAL HOSPITAL, MORONG, RIZAL_________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by:

Printed Name and Signature of Student _________CHARIZE C. SANTIAGO_________

Date Performed and

Time Started

Patient’s INITIAL Only

Case Number(not applicable for Birthing/Lying-

in Clinic/Home)

Immediate Newborn Cord Care

PERFORMEDIndicate where performed e.g. D.R.,

Nursery, NICU, or Home

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

(If Midwife on Duty, Signature Not Required)SUPERVISED BY

Clinical instructorName and Signature

July 7, 20119:25 p.m

Baby Boy L.84

Delivery room Aileen M. Villones, RM Rosemarie M. Sasaki, RN MAN

July 7, 20118:05 p.m

Baby Girl S.74

Delivery room Aileen M. Villones, RM Rosemarie M. Sasaki, RN MAN

July 6, 20113:30 p.m

Baby Boy M.65

Delivery room Rowena D. Eslava, RM Rosemarie M. Sasaki, RN MAN

Noted by: EMILIE M. LOPEZ, RN MAN Approved by: NOLI V. PAGDANGANAN, RN MPA MANClinical Coordinator: PRC I.D. No. 0157036 Valid Until August 28, 2014 Dean: PRC I.D. No.025555 Valid Until October 16, 2013Date document is signed: ________________ Time: ______________ Date document is signed: ________________ Time: _____________Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: BSN, MPA, MAN