ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.

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

SURGICAL SCRUB (Major) in

ST. VICTORIA HOSPITAL______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __ ___ Genilyn R. Venida ________

Date Performed and Time Started

Patients INITIAL Only Case Number

SURGICAL PROCEDURE PERFORMED

O.R. Nurse On Duty (Name and Signature) Levi O. Ubalde R.N Levi O. Ubalde R.N BY

SUPERVISED Clinical instructor Name and Signature Ricardo M. Rico RN. MAN Ricardo M. Rico RN. MAN

August 16, 2011 9:00 AM August 23, 2011 1:00 PM

I.C.C 83428 P.F.G 83552

Cessarian Section Explore Laparotomy Total Abdominal Hysterectomy Bilateral Salphingo Oophorectomy

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Major) in TONDO MEDICAL CENTER Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student __ ___ Genilyn R. Venida ________

Date Performed and Time Started

Patients INITIAL Only Case Number

SURGICAL PROCEDURE PERFORMED

O.R. Nurse On Duty (Name and Signature) Amalia S. Pelagio R.N Ma. Teresa M. Fraga R.N,MAN Ed.D BY

SUPERVISED Clinical instructor Name and Signature Marcelo Lao R.N, R.M, MAN Marcelo Lao R.N, R.M, MAN

October 3, 2011 12:45 PM October 4, 2011 1:20 PM

A.D.B 364605 R.G.L 050012

Cholecystectomy Explore Laparotomy Ligation of Omental Bleeders

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

SURGICAL SCRUB (Major) in TAGUIG DISTRICT HOSPITAL Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student __ ___ Genilyn R. Venida ________

Date Performed and Time Started May 3, 2011 6:28 PM

Patients INITIAL Only Case Number T.L.M 1101042

SURGICAL PROCEDURE PERFORMED

O.R. Nurse On Duty (Name and Signature) John Niro D. Estandarte R.N

SUPERVISED BY Clinical instructor Name and Signature Archimedes G. Balinas R.N ,R.M, MSN

Cessarian Section

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015) SURGICAL SCRUB (Minor) in TAGUIG DISTRICT HOSPITAL___________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __ ___ Genilyn R. Venida _______

Date Performed and Time Started

Patients INITIAL Only Case Number

SURGICAL PROCEDURE PERFORMED

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

SUPERVISED Clinical Name and Signature

May 4, 2011 6:02 PM May 6, 2011 2:30 PM

R.F.L 83546 H.L.M 1101062

Completion and Curettage Excision; Suturing

Jasper S. Afroilan R.N Jhon Niro D. Estandarte R.N

Archimedes G. Balinas R.N, R.M, MSN Archimedes G. Balinas R.N ,R.M, MSN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015) SURGICAL SCRUB (Minor) in ST. VICTORIA HOSPITAL______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student __ ___ Genilyn R. Venida _______

Date Performed and Time Started

Patients INITIAL Only Case Number

SURGICAL PROCEDURE PERFORMED

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

SUPERVISED Clinical instructor Name and Signature Ricardo M. Rico RN. MAN

August 23, 2011 12:00 PM

J.R.M 83546

Dilatation and Curettage

Levi O. Ubalde R.N

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015) SURGICAL SCRUB (Minor) in TONDO MEDICAL CENTER______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started

Patients INITIAL Only Case Number

SURGICAL PROCEDURE PERFORMED

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

SUPERVISED Clinical instructor Name and Signature

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in _____________________OSPITAL NG SAMPALOK_____________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started May 12, 2011 12:35 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

A.A.S 945703

Normal Spontaneous Delivery

Alberto S. Ventura R.N, MAN

Francis S. Mercado R.N,MAN, Ed.D

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph

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

ASSISTED DELIVERY in __________________TONDO MEDICAL CENTER_____________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started August 9, 2011 3:55 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

L.G.E 374159

Normal Spontaneous Delivery

Marly M. Diamzon R.N, RM

Marita P. Lestor R.N, MAN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in __________________TAGUIG DISTRICT HOSPITAL____________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started May 3 ,2011 10:34 PM May 5 ,2011 10:56 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

T.P.D 110144 J.G.R 1101057

Normal Spontaneous Delivery Normal Spontaneous Delivery

Vinamar Rafaela M. Novejas R.M

Archimedes G. Balinas R.N, R.M, MSN Archimedes G. Balinas R.N, R.M ,MSN

Marilyn T. Villadolid R.M

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time:

Highest Nursing Degree Earned: BSN, MAN

Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ACTUAL DELIVERY in __________________ST. VICTORIA HOSPITAL_______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started August 16, 2011 10:00 AM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

B.S.T 83436

Normal Spontaneous Delivery

Levi O. Ubalde R.N, MAN

Ricardo M. Rico R.N, MAN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in __________________OSPITAL NG SAMPALOC_______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started May 10, 2011 4:09 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

J.A.Z 615703

Normal Spontaneous Delivery

Josephine P. Besabe R.M

Mercado Francis S. R.N, MAN, Ed.D

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in __________________ST.VICTORIA HOSPITAL_______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

August 15, 2011 2:00 PM

C.J.D 83417

Normal Spontaneous Delivery

Levi O. Ubalde R.N

Ricardo M. Rico R.N, MAN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in __________________TAGUIG DISTRICT HOSPITAL______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started May 3, 2011 6:52 PM May 5, 2011 7:18 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

M.S.C 1101043 M.R 1101055

Normal Spontaneous Delivery Normal Spontaneous Delivery

Vinamar Rafaela M. Novejas R.M

Archimedes G. Balinas R.N,R.M,MSN Archimedes G. Balinas R.N,R.M,MSN

Marilyn T. Villadolid R.M

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 LOC 222/210, 7353509 Fax, www.arellano.edu.ph PACUCOA Level II Re-Accredited Status (February 2010 to February 2015)

ASSISTED DELIVERY in ____________________TONDO MEDICAL CENTER____________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province

Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started August 8, 2011 5:29 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

M.L.K 374053

Normal Spontaneous Delivery

Evangeline C. Riguer R.N, MAN

Marita P. Lestor R.N, MAN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 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 __________________TONDO MEDICAL CENTER______________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started August 1, 2011 9:30 PM August 2, 2011 7:04 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, NICU, or Home Delivery Room Delivery Room

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

Baby Girl C. 363029 Baby Boy E. 373356

Evalyn Q. Toquero R.N, R.M, MAN Fatima Katrina F. Rosales M.D

Marita P. Lestor R.N, MAN Marita P. Lestor R.N, MAN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN

ARELLANO UNIVERSITY COLLEGE of NURSING 2600 Legarda St., Sampaloc, Manila 7347371 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 ___________________TAGUIG DISTRICT HOSPITAL___________________________________ Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name and Signature of Student__ ___ Genilyn R. Venida _______

Date Performed and Time Started May 2, 2011 10:34 PM May 5, 2011 4:50 PM May 6, 2011 6:05 PM

Patients INITIAL Only Case Number

(not applicable for Birthing/Lyingin Clinic/Home)

Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, NICU, or Home Delivery Room Delivery Room Delivery Room

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical instructor Name and Signature

Baby Boy D. 1101029 Baby Girl B. 1101054 Baby Boy G. 1101065

Rosalinda V. Sitchon R.M Marilyn T. Villadolid R.M Rosalinda V. Sitchon R.M

Archimedes G. Balinas R.N,R.M,MSN Archimedes G. Balinas R.N,R.M,MSN Archimedes G. Balinas R.N,R.M,MSN

Noted by: LEONARDO M. NUESTRO JR., RN, MAN MAN Clinical Coordinator, PRC I.D. No. 190198 Valid Until March 25, 2013 2013 Date document is signed: ________________ Time: ______________ _____________ Highest Nursing Degree Earned: BSN, MAN

Approved by: ROBERTO C. SOMBILLO, RN, RM, Dean, PRC I.D. No. 0172832 Valid Until August 02,

Date document is signed: ________________ Time: Highest Nursing Degree Earned: BSN, Midwifery, MAN