Colegio San Agustin - Bacolod College of Health and Allied Professions
Colegio San Agustin - Bacolod College of Health and Allied Professions
Colegio San Agustin - Bacolod College of Health and Allied Professions
NURSING PROGRAM
Prepared by : ___________________________________
EXAMINEE
DATE PATIENT’S INITIAL ONLY IMMEDIATE NEWBORN CORD D.R. Nurse On Duty SUPERVISED BY:
PERFORMED & TIME STARTED Case Number CARE PERFORMED (Name & Signature) Clinical Instructor
(Not Applicable for Birthing/Lying in Clinics/ (If Midwife on Duty Signature Not Name & Signature
Homes) Indicate where performed e.g. Required)
D.R., Nursery, NCU or Home
(STRICTLY NO DESIGNATES)