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PRC

PRC

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OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student:
CAPLIS, ERWIN REFUERZO
 
 _____ __________________________________________________________________________ 
 
 ________________ Name and Address of School
: OUR LADY OF FATIMA UNEVRSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY___________________ 
Accreditation Level (if any): PACUCOA LEVEL II___________________ 
 
 __Year Granted: April 10, 2002___________________________________________________________ Date School/Program was Recognized: April 25, 2001
 
 ________________Number: 033________________________Year: 2001______________________________________First Course (if any) :__NOT APPLICABLE___ ___________________ School Graduated From: _NOT APPLICABLE
 
 __Year: NOT APPLICABLE
 
 ________________________Year of Admission in the Bachelor of Science in Nursing Program: _2003__________________________________________________________________________________ Year Graduated (BSN Program): _2009
 
 _____________________________________________________________________________________________________________ 
II. Minor Operations
No.Date of OperationCaseNo.Name of PatientDiagnosisOperationPerformedType of AnesthesiaName of SurgeonName of HospitalName of Qualified CISignature of Qualified CI1.
December 16,200711607126558Jonalyn MendozaIncomplete AbortionGravida3 Para2Dilatation andCurettageIntravenousAnesthesiaDra. PricillaQuiambaoBulacan Maternityand ChildrensHospital
Marcellus C. BelisarioRN,MAN
PRC No: 0349993PNA No: 19636
2.
November 19,2007111907134348Amante NonitaBilateral Tubal LigationGravida6 Para3Bilateral TubalLigationSpinal AnesthesiaDra. PricillaQuiambaoBulacan Maternityand ChildrensHospital
Marcellus C. Belisario
PRC No: O349993PNA No: 19636
3.
May 13 ,2008369700 Catilo BenedictLacerated Wound RightTemporalSuturing of WoundLocal AnesthesiaDr. Mark LouieBatangasRegional HospitalJonel Ramirez RN, MANPRC No; 450849PNA No: 2256
4.
May 13, 2008369935Alilio John HilbertInfected Wound Left FootDebridementLocal AnesthesiaDr. Edmund Reyes
Batangas RegionalHospital
Jonel Ramirez RN, MANPRC No: 450849PNA No: 2256
5.
May 13, 2008369937Mark KienMacalaladUncircumcised PenisCircumcissionLocal AnesthesiaDra. Clareta Dita
Batangas RegionalHospital
Jonel Ramirez RN,MANPRC No: 450849PNA No: 2256
 
 
Prepared by:
CAPLIS, ERWIN REFUERZO
 __ Signature over printed Name of StudentSupervised by:
MARCELLUS C. BELISARIO,RN,MAN
Signature over printed name of FacultyDate Signed: ____________________ Degree: RN,MAN________ PRC No: 0349993___________ ___ Valid Until: September 12, 2012__ PNA No: 19636 ______________ Valid Until:_Liifetime ____ Noted by:
Mrs. MARISOL GARCIA-MANIPOL,RN,MAN
Signature over printed name of ClinicalCoordinator Date Signed: ______________________ Degree:__BSN, MAN________________ 
a.)
PRC NO: _0296870_____________ Valid Until: September 2012______ b.) PNA NO: __025883 _____________ Valid Until:_December 2009 ______ Approved by:
NELIA R. CAPULONG,_RN,RM,MAN____ 
Signature over printed name of Dean
,
Date Signed: ______________________ Degree:_BSN,RN, RM, MAN_________ 
a.)
PRC NO: 0041904______________ Valid Until: July 31, 2012______ __ b.) PNA NO: 18698__________________ Valid Until: Lifetime______________ 
b.)
ADPCN NO:_0627______________ Valid Until: December 2009 _______ Concurred by:
MINERVA N. ESPINO, RN, ____ 
 __ Signature over printed name of Chief NurseDate Signed: _______________________ Degree:_RN,BSN___________________ a.) PRC NO: 0090530_________________ Valid Until: October 10, 2009_________ b.) ANSAP NO: ______________________ Valid Until: _______________________ c.) PNA NO: _19638 ________________ Valid Until: Lifetime _______ Concurred by:
AMOR CALAYAN, RN,RM,MAN,PH.D.__ 
Signature over printed name of Chief NurseDate Signed: ______________________ Degree:_BSN,RM,MAN,RN, PhD_______ a.) PRC NO: _151514 ______ Valid Until: August 2010__________ b.) PNA NO: _038801____ _________ Valid Until: December 2009_______ 
 
 
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student:
CAPLIS, ERWIN REFEURZO
__________________________________________________________________________________-__________________ Name and Address of School:
OUR LADY OF FATIMA UNIVERSITY #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY___________________ 
Accreditation Level (if any): PACUCOA LEVEL II_____________________Year Granted: April 10, 2002____________________________________________________________ Date School/Program was Recognized: April 25, 2001
 
 ________________Number: 033 Year: 2001_____________________________________________ First Course (if any) :_NOT APPLICABLE____ ___________________ School Graduated From: NOT APPLICABLE____Year: NOT APPLICABLE_______________________ Year of Admission in the Bachelor of Science in Nursing Program: 2003___________________________________________________________________________________ Year Graduated (BSN Program): 2009
 
 ______________________________________________________________________________________________________________ 
I. Major Operations
No.Date of OperationCase No.Name of PatientDiagnosisOperationPerformedType of AnesthesiaName of SurgeonName of HospitalName of Qualified CISignature of Qualified CI1.Decembe13, 2007132732Basillo RuthPregnancy Uterine 37weeks gestation Cephalicin Labor Para6CaesarianSectionSpinalAnesthesiaDra. Ma.Grace AgnesBautistaBulacan Maternityand ChildrensHospitalMarcellus C. BelisarioRN,MANPRC No: 0349993PNA No: 196362.December 19, 2007088171Ma. ThersaCastroPregnancy Uterine FullTerm, cephalic in Labor Gravida3 Para1CaesarianSectionSpinalAnesthesiaDra. PricillaQuiambaoBulacan Maternityand ChildrensHospitalMarcellus C. BelisarioRN,MANPRC No: 0349993PNA No: 196363.August 27,2008381315Rodel DayteRuptured AppendixExploratoryLaparotomySubarachnoidAnesthesiaDr. AristotleArellanoBatangas RegionalHospitalJonel Ramirez RN,MANPRC No;450849PNA No: 22564.August 29,2008373456Jose BenemerCholelithiasis
Cholecystectomy
CombinedSpinal andEpeduralAnesthesiaDr. JoseTenorioBatangas RegionalHospitalJonel Ramirez RN,MANPRC No: 450849PNA No: 22565.August 29,2008364339Edgardo PaneExploratory LaparotomycolostomyClosure of colostomySubarachnoidAnesthesiaDr. AristotleArellanoBatangas RegionalHospitalJonel Ramirez RN,MANPRC No: 450848PNA NO: 2256
 
Concurred by:
AMOR CALAYAN RN,RM,MAN,PH.D.
Signature over printed name of Chief NurseDate Signed: _______________________ Degree:_BSN, RN_RM,MAN, PH.D._____ a.) PRC NO: _151514 _____________ Valid Until: _August 2010____________ b.) PNA NO: _038801 ______________ Valid Until: _December 2009_______ Approved by:
NELIA R. CAPULONG, RN,RM,MAN__ 
Signature over printed name of DeanDate Signed: ______________________ Degree:_BSN RN,RM, MANMAN______ 
c.)
PRC NO: 0041904______________ Valid Until: July 31, 2012 _______ b.) PNA NO: 18698__________________ Valid Until: Lifetime______________ c.) ADPCN NO:_0627________________ Valid Until: December 2009_________ Concurred by:
_MINERVA ESPINO, RN ____ 
Signature over printed name of Chief NurseDate Signed: ______________________ Degree:_BSN,RN___________________ a.) PRC NO:_0090530________________ Valid Until: October 10, 2009________ b.) ANSAP NO: _____________________ Valid Until: ______________________ c.) PNA NO: 19638 _______________ Valid Until: _Lifetime _______ Noted by: 
MRS. MARISOL GARCIA-MANIPOL,RN,MAN
Signature over printed name of ClinicalCoordinator Date Signed: ______________________ Degree:__BSN, MAN________________ 
b.)
PRC NO: _0296870_____________ Valid Until: September 2012______ b.) PNA NO: __025883______________ Valid Until:_December 2009______ Prepared by:
CAPLIS, ERWIN REFUERZO
 ___ Signature over printed Name of Student
 
Supervised by:
JONEL RAMIREZ, RN,MAN ______ 
Signature over printed name of FacultyDate Signed: ____________________ Degree: RN,MAN________________ PRC No: 450849_________________ Valid Until: September 2010_____ 
PNA No: 2256 _____________ Valid Until: December 2009
 
OUR LADY OF FATIMA UNIVERSITY#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student:
CALIS ERWIN REFUERZO
 
 _______________________________________________________________________________ 
 
 __________________ Name and Address of School:
OUR LADY OF FATIMA UNEVRSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________ 
Accreditation Level (if any): PACUCOA LEVEL II
 
 _____________________Year Granted: April 10, 2002
 
 ___________________________________________________________ Date School/Program was Recognized: April 25, 2001
 
 ________________Number: 033________________________Year: 2001______________________________________First Course (if any) :NOT APPLICABLE_________________ School Graduated From: NOT APPLICABLE__Year:__NOT APPLICABLE________________________________ Year of Admission in the Bachelor of Science in Nursing Program: _2003__________________________________________________________________________________ Year Graduated (BSN Program): _2009
 
 _____________________________________________________________________________________________________________ 
III. Actual Deliveries
No.Case No.DiagnosisName of Mother AgeDate of DeliveryTime of DeliveryGender of BabyName of HospitalType of DeliverySupervised by: Name and Signature of Qualified C.I.1.
142607Pregnancy Uterine Full TermGravida 2, Para 0, 39 weeks Ageof Gestation, Cephalic in Labor 
Melissa Corpus
27Jily 23, 20072:06 amFemaleNovaliches DistrictHospitalNormalSpontaneousDeliveryRosanie C. Moro RN,PH.DPRC No: 66491PNA NO: 25665
2.
161401Pregnancy Uterine Full TermGravida 2, Para 1 39 weeks Ageof Gestation, Cephalic in Labor Aquino Karen26June 3, 200812:10 amFemaleNovaliches DistrictHospital
NormalSpontaneousDelivery
Rosanie C. Moro RN,PH.DPRC No: 66491PNA No: 25665
3.
621134Pregnancy Uterine Full TermGravida 4, Para 3, 39 weeks Ageof Gestation, Cephalic in Labor Sally Almodan34November 16,20087:30 pmMaleOspital ng Lungsod ngSan Jose Del MonteBulacan
NormalSpontaneousDelivery
Norberta Alcarion RN,RM,MANPRC No: 170101PNA No: 1077
4.
398629Pregnancy Uterine Full TermGravida 1, Para 0, 38 weeks Ageof Gestation, Cephalic in Labor Maricar Ruego24January 3,200911:00 pmFemaleOspital ng Lungsod ngSan Jose Del MonteBulacan
NormalSpontaneousDelivery
Norberta C. Alcarion RN,RM,MANPRC No: 170101PNA No: 1077
5.
398586Pregnancy Uterine Full TermGravida 2, Para 1 38 weeks Ageof Gestation, Cephalic in Labor Celerina Arias21January 4,20097:40 pmFemaleOspital ng Lungsod ngSan Jose Del MonteBulacan
NormalSpontaneousDelivery
Norberta C. Alcarion RN,RM,MANPRC No: 170101PNA No: 1077
 
Concurred by:
ESTELITA B. LORENZO RN,RM,MAN
Signature over printed name of Chief NurseDate Signed: _______________________ Degree:_RN,RM,MAN __________ a.) PRC NO: _0111348________________ Valid Until: September 3, 2011_______ b.) PNA NO: 1078 _____________ Valid Until: _December 2009_________ Approved by:
NELIA R. CAPULONG, RN, RM, MAN__ 
Signature over printed name of DeanDate Signed: ______________________ Degree:_BSN, RM, MAN_____________ 
d.)
PRC NO: 0041904______________ Valid Until: July 31, 2012________ b.) PNA NO: 18698__________________ Valid Until: Lifetime______________ c.) ADPCN NO:_0627________________ Valid Until: December 2009_________ Concurred by:
JOSEPHINE B.LEONARDO_RN,MAN,PH.D.
Signature over printed name of Chief NurseDate Signed: ___________________ Degree: BSN,RN,MAN, PH.D_______ a.) PRC NO:
0081174
 
 __________ 
 
Valid Until:_ 
 
 April 3, 2011
 
 _____ 
 
b.) PNA NO: _15614______________ 
 Valid Until:_Lifetime____
 
Noted by:
Mrs. MARISOL GARCIA- MANIPOL,RN,MAN
Signature over printed name of ClinicalCoordinator Date Signed: ______________________ Degree:__BSN,RN, MAN____________ 
c.)
PRC NO: _0296870_____________ Valid Until: September 2012 _____ b.) PNA NO: __025883 ____________ Valid Until: December 2009______ Prepared by:
CAPLIS, ERWIN REFUERZO
 __ Signature over printed Name of StudentSupervised by:
NORBERTA C.ALCARION,RN,RM,MAN
Signature over printed name of FacultyDate Signed: ___________________ Degree: _BSN,RN,RM, MAN
PRC No
 
: 170101 __________ 
 
 Valid Until; June 6, 2012____ 
PNA No
: 1077 ___________ 
Valid Until:
December 2009

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