wella cases.doc
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PROFESSIONAL REGULATION COMMISSION Manila BOARD OF MIDWIFERY ° Records of Actual Deliveries Handled Please check if the Applicant is: Graduate Midwife Registered Nurse Name of Applicant: TANIOLA, WELLA JOIE C. School: BROKENSHIRE COLLEGE SOCSKSARGEN INC. Name and Address of the Patient Case No. Complete Diagnosis (Gravida_Para_) Date & Time Performed Full name, Address of the Facility & Contact No. Supervised By: Printed Name & Contact No. Position/ Designation Signature License No./ Exp. Date 1. Ramirez, Karen Dyne Calabanit, Glan Sarangani Province 1402002136 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male neonate in cephalic presentation, 39 weeks and 6/7 days Age of Gestation, Gravida 1 Para 0 February 26, 2014 8:59 pm General Santos City Hospital 083-3015866 Arline J.Magan 09325148837 Clinical Instructor License No. RN 0134411 Expiry Date: November 15, 2015 License No. RM 0162958 Expiry Date: November 15, 2015 2. Dayanan, Cherlita Purok 8A Alabel Sarangani Province 1403002842 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 2 Para 1 March 18, 2014 11:21 am General Santos City Hospital 083-3015866 Arline J. Magan 09325148837 Clinical Instructor License No. RN 0134411 Expiry Date: November 15, 2015 License No. RM 0162958 Expiry Date: November 15, 2015 3. Tusan, Stephanie Aiza Purok 10 Alabel Poblacion Sarangani Province 1405004337 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0 May 8, 2014 8:50 pm General Santos City Hospital 083-3015866 Arline J. Magan 09325148837- Clinical Instructor License No. RN 0134411 Expiry Date: November 15, 2015 License No. RM 0162958 Expiry Date: November 15, 2015 4. Pines, Jocelyn Balite, Lagao General Santos City 1405004725 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male neonate in cephalic presentation, 39 weeks Age of May 15, 2014 8:04 pm General Santos City Hospital 083-3015866 Arline J. Magan 09325148837 Clinical Instructor License No. RN 0134411 Expiry Date: November 15, 2015 License No. RM 0162958 Expiry Date: November 15, 2015
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PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY°
Records of Actual Deliveries Handled
Please check if the Applicant is:
Graduate Midwife Registered Nurse
Name of Applicant: TANIOLA, WELLA JOIE C. School: BROKENSHIRE COLLEGE SOCSKSARGEN INC.
Name and Address
of the PatientCase No. Complete Diagnosis
(Gravida_Para_)Date & Time Performed
Full name, Address of the Facility & Contact No.
Supervised By:
Printed Name &Contact No.
Position/ Designation
Signature License No./ Exp. Date
1. Ramirez, Karen Dyne
Calabanit, Glan Sarangani Province
1402002136 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 39 weeks and 6/7 days Age
of Gestation, Gravida 1 Para 0
February 26, 20148:59 pm
General Santos City Hospital
083-3015866
Arline J.Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Dayanan, Cherlita
Purok 8A Alabel Sarangani Province
1403002842 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 38 weeks Age of Gestation,
Gravida 2 Para 1
March 18, 201411:21 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Tusan, Stephanie Aiza
Purok 10 Alabel Poblacion Sarangani Province
1405004337 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 38 weeks Age of Gestation,
Gravida 1 Para 0
May 8, 20148:50 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837-
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Pines, Jocelyn
Balite, Lagao General Santos City
1405004725 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 39 weeks Age of Gestation,
Gravida 1 Para 0
May 15, 20148:04 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Legaspi, Juvelyn
Purok 8A Poblacion Malapatan, Sarangani Province
1406005966 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 40 weeks Age of Gestation,
Gravida 2 Para 1
June 19, 20148:49 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
6 Bautista, Maria Cristy
Zone 2-C Bula General Santos City
1406005957 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 39 weeks Age of Gestation, Gravida 12 Para 11 Pre-Eclampsia, severe
June 20, 201410:01 am
General Santos City Hospital
083-3015866
Arline J.Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
7. Torregoza, Teodora
Poblacion Malapatan, Sarangani Province
1407006439-B Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 40 weeks and 3/7 days Age
of Gestation, Gravida 8 Para 9
July 3, 20147:59 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
8. Manza, Flordeliz
Purok Kalonlama Kihan
1407006472 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 38 weeks and 2/7 days Age
of Gestation, Gravida 1 Para 0
July 4, 20147:40 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837-
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
9. Beto, Ana Rose
Purok 2, Tinagacan General Santos City
14070069440. Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 41 weeks and 1/7day Age of Gestation, Gravida 2 Para 1 Pre-Eclampsia
July 18, 20143:50 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
10. Eclapis, Barbara
Block 16, Lot 5 Employees Village, Fatima General Santos City
1407006967 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 38 weeks and 4/7 days Age
of Gestation, Gravida 1 Para 0, Pre-Eclampsia, severe
July 18, 201410:00 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
11. Alcantara, Marjilyn
Purok San Nicolas Lun Padido, Malapatan Sarangani Province
1407007166 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 40 weeks and 1/7 day Age of Gestation, Gravida 3 Para 2, Previous
Ceasarian
July 24, 20147:07 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
12 Jover, Honey Pearl Ire
Purok Pisces Street, Calumpang General Santos City
1407007234 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 38 weeks Age of Gestation,
Gravida 2 Para 1
July 26, 20143:44 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411 Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
13. Alinsugay, Bebeth
Purok 5 Poblacion Malapatan Sarangani Province
1407007450 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 40 week Age of Gestation,
Gravida 1 Para 0
July 31, 20142:48 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
14. Mamada, Lynlyn
San Juan, Silway Dadiangas West General Santos City
1408008056 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 39 weeks Age of Gestation,
Gravida 4 Para 3 Abortion 1
August 16, 20146:13 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
15. Abiso, Anacel
Tinago 9-B, Dadiangas South General Santos City
1408008236 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a female neonate in cephalic presentation, 39 weeks and 6/7 days Age
of Gestation, Gravida1 Para 0
August 22, 20148:02 am
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
16. Recibas, Magdalena
Purok 2 Ligaya General Santos City
1408008265 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 39-40 weeks Age of
Gestation, Gravida 7 Para 6
August 22, 201412:46 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
17. Franco, Miaflor
Labangal, General Santos City
1409009243 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 38 weeks Age of Gestation,
Gravida 8 Para 7
September 18, 201410:35 am
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
18 Ensomo, Rebecca
Calumpang, General Santos City
1409009519 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation,40 weeks and 6/7 days Age
of Gestation, Gravida 1 Para 0
September 25, 201412:35 pm
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
19. Dianga, Junalyn
Malalag, Cogon Malungon Sarangani Province
1410009763 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in breech presentation footling, 41 weeks and 2/7
days Age of Gestation, Gravida 2 Para 1
October 2, 201411:19 am
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
20. Villarba, Madelyn
Purok Balunto Labangal General Santos City
1410010000 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal
Delivery to a male neonate in cephalic presentation, 39 weeks and 3/7 days Age
of Gestation, Gravida 1 Para 0
October 9, 20148:50 am
General Santos City Hospital 083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) for graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
Affix Doc. Stamp
(To be posted on the last page)
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Records of Cord Dressing
Please check if the Applicant is:
Graduate Midwife Registered Nurse
Name of Applicant: TANIOLA, WELLA JOIE C. School: BROKENSHIRE COLLEGE SOCSKSARGEN INC.
No. Date of Birth and Time
Family Name of Child
Sex Mother Weight In lbs.
Length In Cms.
Head Cms.
Temperature Name who Cord Dressed
Full name, Address of the
Facility & Contact No.
Supervised by:
Clinical Instructor License No./ exp. Date Signature Hospital Case No.
1. January 26, 2014
6:30 pm
Soriba Female Soriba, Jane 6.38 lbs. 48 cm 33 cm 36.8 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1401001030
2. March 04, 2014
12:02 pm
Rosales Female Rosales, Jenive
6.38 lbs. 47 cm 34 cm 37.5 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1403002362
3. March 11, 2014
10:09 am
Madio Female Madio, Leah Grace
6.38 lbs. 46 cm 33 cm 37.1 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1403002595
4. March 17, 2014
04:00 pm
Batoctoy Male Batoctoy, Ruffa Jean
6.82 lbs. 48 cm 36 cm 36.0 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1403002742
5. April 24, 2014
05:48 pm
Villacorte Male Villacorte, Geraldine
6.6 lbs. 52 cm 33 cm 37.7 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1404004040
6. May 02, 2014
07:43 pm
Masabio Male Masabio, Jovelyn
6.38 lbs. 51 cm 32 cm 36.7 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1405004274
7. May 08, 2014
09:19 pm
Sobel Male Sobel, Melanie 6.6 lbs. 49 cm 34 cm 37.4 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1405004483
8. May 23, 2014
04:57 pm
Bensorto Female Bensorto, Jimvic
6.16 lbs. 46 cm 31 cm 36.9 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1405004996
9. May 23, 2014
09:26 pm
Sabdullah Female Sabdullah, Munirah
5.5 lbs. 50 cm 30 cm 37.1 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1405005008
10. June 20, 2014
08:20 am
Lopez Male Lopez, Daniela 7.04 lbs. 51 cm 32 cm 37.3 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1406005982
11. July 03, 2014
09:36 am
Josoy Female Josoy, Jenny Rose
5.28 lbs. 47 cm 32 cm 37.6 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407006437
12. July 4, 2014
08:54 pm
Sagad Female Sagad, Michel 6.16 lbs. 51 cm 32 cm 37.8 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407006484
13. July 04, 2014
10:15 am
Requilme Male Requilme, Aileen Hazel
5.5 lbs. 47 cm 33 cm 37.0 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407006488
14. July 19, 014
03:35 pm
Pineda Male Pineda, Lovella 6.16 lbs. 43 cm 32 cm 36.6 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407006997
15. July 24, 2014
05:42pm
Lanubay Female Lanubay, Shenna Mae
6.16 lbs. 50 cm 31 cm 36.2 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407007172
16. July 26, 2014
04:45 pm
Organiza Female Organiza, Sarah May
6.38 bs. 49 cm 32 cm 36.6 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1407007229
17. August 01, 2014
11:11 am
Damie Male Damie, Raipa 6.16 lbs. 53 cm 33 cm 36.3 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1408007477
18. August 08, 2014
07:10 pm
Escribano Male Escribano, Jonezy
9.46 lbs. 54 cm 35 cm 36.2 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1408007718
19. August 17, 2014
04:45 pm
Alba Female Alba, Ellen 5.5 lbs. 48 cm 32 cm 37.2 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1408008087
20. August 22, 2014
09:50 am
Gonzaga Male Gonzaga, Jessa
6.6 lbs. 49 cm 33 cm 35.3 °C Taniola, Wella Joie C. General Santos City Hospital
083-3015866
Arline J. Magan RN, RM09325148837
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
1408008261
Note: 1.) for graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Affix Doc. Stamp
(To be posted on the last page)
Records of Actual Intravenous Insertions
Please check if the Applicant is:
Graduate Midwife Registered Nurse
Name of Applicant: TANIOLA, WELLA JOIE C. School: BROKENSHIRE COLLEGE SOCSKSARGEN INC.
No. Name and Address of Patient
Case No. Complete Diagnosis(Gravida_Para_)
Date & Time
Perfomed
Full name, Address of the Facililty & Contact No.
Supervised By:
Printed Name & Contact No.
Position/ Designation
Signature License No./ Exp. Date
1. Abellano, Judy Ann
Zone 3, Block 5, Barangay Fatima Uhaw General Santos City
1405004238 Pregnancy Uterine Full Term in labor delivered via Normal
Spontaneous Vaginal Delivery to a male neonate in cephalic
presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
May 2, 20145:35 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Inso, Noreen Grace
Purok 5, Block 4, Barangay Fatima Uhaw General Santos City
1407006414 Pregnancy Uterine Full Term in labor delivered via Normal
Spontaneous Vaginal Delivery to a male neonate in cephalic
presentation, 39 weeks and 5/7 days Age of Gestation, Gravida 1
Para 0
July 4, 201410:48 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Taborado, Dona Rose
Purok 6 Poblacion Maasim, Sarangani Province
1408008250 Pregnancy Uterine Full Term in labor delivered via Normal
Spontaneous Vaginal Delivery to a male neonate in cephalic
presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
August 22, 20148:05 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Mantalaba, Joan
Purok Bag-o, Malalag Poblacion Maitum, Sarangani Province
1411011159 Pregnancy Uterine Full Term in labor delivered via Normal
Spontaneous Vaginal Delivery to a female neonate in cephalic
presentation, 39 weeks Age of Gestation, Gravida 1 Para 0
Nov. 13, 20148:04 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Girvan, Jorfa
Purok Malinawon, Tuyan Malapatan Sarangani Province
1412012042 Pregnancy Uterine Full Term in labor delivered via Normal
Spontaneous Vaginal Delivery to a neonate in cephalic presentation,
39 weeks Age of Gestation, Gravida 1 Para 2
December 10, 20141:07 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) For graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public
CERTIFIED CORRECT:
Signature:_______________Date:___________
Printed Name: Sersosa B. Aromin, RM,RN,MAN Designation: Dean/Principal
Lic. No: RM 0027789 Exp. Date: 2/20/15 Lic. No: RN 0428561 EXP. Date: 2/28/16
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Records of Actual Suturing of Perineal Lacerations
Please check if the Applicant is:
Affix Doc. Stamp
(To be posted on the last page)
Graduate Midwife Registered Nurse
School: BROKENSHIRE COLLEGE SOCSKSARGEN INCORPORATED
Name of Applicant: TANIOLA, WELLA JOIE C.
No. Name and Address of Patient
Case No.
Complete Diagnosis(Gravida_Para_)
Date & Time Perfomed
Full name, Address of theFaculty & Contact No.
Supervised By:
Printed Name & Contact No.
Position/ Designation Signature License No./ Exp. Date
1. Manza, Flordeliz
Purok Kalonlama Kihan
1407006472
Full term male neonate 38 weeks AOG G1 P1s
July 4, 20148:05 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Abiso, Anacel
Tinago 9-B Dadiangas South General Santos City
1408008236
Full term female neonate 39 weeks AOG G1 P1
August 22, 20148:22 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Ensomo, Rebecca
Calumpang, General Santos City
1409009519
Full term male neonate 40 weeks G1 P1 September 25, 20141:05 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Villarba, Madelyn
Purok Balunto, Labangal General Santos City
1410010000
Full term male neonate 39 weeks AOG G1 P1
October 9, 20149:15 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
Clinical Instructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Estrada, Jovelyn
Purok Santa Ana Lucia, Pangyan Glan Sarangani Province
1411011371
Full term male neonate 40 weeks AOG G1 P1
November 19, 201412:30 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
Clinical Instructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) For graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
Printed Name: Sersosa B. Aromin, RM,RN,MAN Designation: Dean/Principal
Lic. No: RM 0027789 Exp. Date: 2/20/15 Lic. No: RN 0428561 EXP. Date: 2/28/16
Affix Doc. Stamp
(To be posted on the last page)
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Records of Assisted Deliveries
Please check if the Applicant is:
Graduate Midwife Registered Nurse
School: BROKENSHIRE COLLEGE SOCSKSARGEN INCORPORATED
Name of Applicant: TANIOLA, WELLA JOIE C.
Name and Address of the Patient
Case No. Complete Diagnosis(Gravida_Para_)
Date & Time Performed
Full name, Address of the Facility & Contact
No.
Supervised By:
Printed Name & Contact No.
Position/ Designation
Signature License No./ Exp. Date
1. Lagang, Mary Ann
Carcon Village Purok 13 Lagao, General Santos City
1401000787 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in cephalic presentation, 38 weeks Age of
Gestation, Gravida 5 Para 4
January 22, 201410:59 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Hinuguin, Robelyn
Valencia Alegria, Sarangani Province
1401000900 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 41 weeks Age of Gestation, Gravida 3 Para 2
January 26, 20145:30 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Dingal, Emelyn
Purok Magiting, Townsite Buayan General Santos City
1403002334 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in cephalic presentation, 40 weeks Age of
Gestation, Gravida 1 Para 0
March 4, 20147:56 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Delina, Gladys Maybel
Malungon, Sarangani Province
1403002835 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 39 weeks and 4/7 days Age of Gestation, Gravida 1 Para 0
March 18, 20142:19 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Abellano, Judy Ann
Zone 3, Block 5, Barangay Fatima Uhaw General Santos City
1405004238 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
May 2, 20148:20 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
6. Sese, Evelyn
KPS Mabuhay, General Santos City
1405004494 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 40 weeks and 4/7 days Age of Gestation, Gravida 4 Para 3
May 8, 20149:55 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
7. Taguding, Lovelyn Mae
Springville, Apopong General Santos City
1406005956 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
June 19, 20145:21 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
8. Desaville, Evelyn
Klinan 5, Mabuhay General Santos City
1406005988 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks and 5/7 days Age of Gestation, Gravida 3 Para 2
June 20, 201410:50 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
9. Inso, Noreen Grace
Purok 5, Block 4, Barangay Fatima Uhaw General Santos City
1407006414 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 39 weeks and 5/7 days Age of Gestation, Gravida 1 Para 0
July 4, 20143:25 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
10. Sardido, Jesame
San Pedro Extension Lagao, General Santos City
1407007251 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
July 26, 20146:33 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
11. Albarida, Catherine
Purok 7 Baluntay Alabel, Sarangani Province
1408007820 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female
neonate in cephalic presentation,38 weeks and 4/7 days Age of Gestation, Gravida 4 Para 3
August 10, 20145:01 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
12. Taborado, Dona Rose
Purok 6 Poblacion Maasim Sarangani Province
1408008250 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
August 22, 201411:30 am
General Santos City Hospital
083-3015866
Arline Jerusalem-Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
13. Bantilan, Rehina
Sitio Glamang, Datal Anggas,Polomolok South Cotabato
1408008272 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
August 22, 20144:20 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
14. Revilla, Romielyn
Purok 4, Cogonal Alabel Sarangani Province
1410010038 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks and 6/7 days Age of Gestation, Gravida 2 Para 1
October 10, 20149:08 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
15. Patcheo, Angelica
Purok Pantay-pantay, Baluan General Santos City
1411011147 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a male
neonate in cephalic presentation, 38 weeks Age of Gestation, Gravida 1 Para 0
November 12, 20141:00 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
16. Obejero, Amy
Purok 16, B-4 Fatima General Santos City
1411011176 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in breech presentation, 38 weeks Age of
Gestation, Gravida 2 Para 3
November 13, 20148:44 am
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
17. Mantalaba, Joan
Purok Bag-o, Malalag Poblacion, Maitum Sarangani Province
1411011159 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in cephalic presentation, 39 weeks Age of
Gestation, Gravida 1 Para 0
November 13, 201412:07 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
18. Girvan, Jorfa
Purok Malinawon, Tuyan Malapatan, Sarangani Province
1412012042 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female neonate in cephalic presentation, 39 weeks Age of
Gestation, Gravida 1 Para 2
December 10, 20146:22 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
19. Corompido, Rechelle Mae
Crisostomo, Calumpang General Santos City
1412012017 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery t0 female
neonate in cephalic presentation, 39 weeks Age of Gestation, Gravida 1 Para 0
December 11, 201412:53 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
20. Balabagan, Arbaina
Sarif Mucsin, Baluan General Santos City
1501000211 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous Vaginal Delivery to a female
neonate in cephalic presentation, 39 weeks and 2/7 days Age of Gestation, Gravida 2 Para 1
January 7, 20151:40 pm
General Santos City Hospital
083-3015866
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) For graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this _________________at______________________ Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
Printed Name: Sersosa B. Aromin, RM,RN,MAN Designation: Dean/Principal
Lic. No: RM 0027789 Exp. Date: 2/20/15 Lic. No: RN 0428561 EXP. Date: 2/28/16
Affix Doc. Stamp
(To be posted on the last page)
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Records of Actual Intravenous Insertions
Please check if the Applicant is:
Graduate Midwife Registered Nurse
School: BROKENSHIRE COLLEGE SOCSKSARGEN INC.
Name of Applicant: ENCARNACION, MARY JOY BAUTISTA
No. Name and Address of Patient
Case No. Complete Diagnosis(Gravida_Para_)
Date & Time
Perfomed
Full name, Address of the Facililty & Contact No.
Check If
Home Del.
Supervised By:
Printed Name & Contact No.
Position/ Designation
Signature License No./ Exp. Date
1. Marites Malinao
Look Basag South Cotabato
1306007203
Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation, 39 week s day
Age of Gestation, Gravida 1 Para 0
June 27,20139:22am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Irene Mendoza
Dambol palimbang South Cotabato
1305005081
Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation, 40 weeks 5 days
Age of Gestation, Gravida 2 Para 1
May 3,20139:am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Majorie Ortiz
Roseville mabuhay General Santos City
1306007229
Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a male neonate in cephalic presentation, 39 weeks Age of
Gestation, Gravida 1 Para 0
June 27,,201311:33am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Zosina Zaballero
Purok 5, Apopong General Santos Cty
1306006907
Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation,36 weeks 1 day
Age of Gestation, Gravida 3 Para 2
June 19, 20139:46am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Dela Cruz, Jamila
1st Brgy. Lagao Crossing Conel Sunga Farm General Santos City
01-0451 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation, 39 weeks 5 days
Age of Gestation, Gravida 3 Para 3
October 4,20122:00am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) For graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
Printed Name: Sersosa B. Aromin, RM,RN,MAN Designation: Dean/Principal
Lic. No: RM 0027789 Exp. Date: 2/20/15 Lic. No: RN 0428561 EXP. Date: 2/28/16
Affix Doc. Stamp
(To be posted on the last page)
PROFESSIONAL REGULATION COMMISSIONManila
BOARD OF MIDWIFERY
Records of Actual Suturing of Perineal Lacerations
Please check if the Applicant is:
Graduate Midwife Registered Nurse
School: BROKENSHIRE COLLEGE SOCSKSARGEN INCORPORATED
Name of Applicant: ENCARNACION, MARY JOY BAUTISTA
No. Name and Address of Patient
Case No.
Complete Diagnosis(Gravida_Para_)
Date & Time Perfomed
Full name, Address of theFaculty & Contact No.
Check If
Home Del.
Supervised By:
Printed Name & Contact No.
Position/ Designation
Signature License No./ Exp. Date
1. Calanao, Shina
San Miguel CalumpangGeneral Santos City
01-0448 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a male neonate in cephalic presentation, 38 weeks 2 days
Age of Gestation, Gravida 1 Para 1
February 4, 20127:40am
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
2. Ronulo, Cherry Love
Tiesa St. Dadiangas NorthGeneral Santos City
01-0455 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation, 39 week s 1 day
Age of Gestation, Gravida 1 Para 1
August 2, 201211:00pm
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
3. Manlaba, Tiny
Placida Brgy. CalumpangGeneral Santos City
01-0456 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a male neonate in cephalic presentation, 37 weeks 5 days
Age of Gestation, Gravida 1 Para 1
August 13, 20124:30pm
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
4. Magan, Mary Claire
City HeightsGeneral Santos City
01-0454 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a male neonate in cephalic presentation, 40 weeks day Age of Gestation, Gravida 1 Para 1
August 25,201212:30pm
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
5. Angos, Ann
Prk. Wal, Brgy. Tambler General Santos City
01-0457 Pregnancy Uterine Full Term in labor delivered via Normal Spontaneous
Vaginal Delivery to a female neonate in cephalic presentation, 38 weeks 5 days
Age of Gestation, Gravida 1 Para 1
September 24, 201211:pm
Brokenshire College SOCSKSARGEN Inc. Lying-in Ced Avenue, National
Highway,General Santos City
083-3049509
Arline J. Magan
09325148837
ClinicalInstructor
License No. RN 0134411Expiry Date: November 15, 2015
License No. RM 0162958Expiry Date: November 15, 2015
Note: 1.) For graduate midwives: Supervision must be by qualified/ clinical instructor. 2.) Registered Midwifes/ Clinical Instructors who supervise the student midwives and the affix their signature in this form must be present a Certificate of Training on Intravenous to the Board pursuant to Board Resolution No. 100, Series of 1993, dated December 1, 1993.
SUBSCRIBED AND SWORN TO before me this_________________at______________________Affiant exhibiting to me his/her Residence Certificate No.02735805 issued at General Santos City on March 11, 2013
Administering Officer or Notary Public CERTIFIED CORRECT:
Signature:_______________Date:___________
Printed Name: Sersosa B. Aromin, RM,RN,MAN Designation: Dean/Principal
Lic. No: RM 0027789 Exp. Date: 2/20/15 Lic. No: RN 0428561 EXP. Date: 2/28/16
Affix Doc. Stamp
(To be posted on the last page)
