Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion

OUR LADY OF FATIMA UNIVERSITY
#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: GARCIA, JAMIE LYNN CARTAGENA .
Name and Address of School: Our Lady Of Fatima University; #1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City .
Accreditation Level (if any): PACU COA 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: 2004 .
Year Graduated (BSN Program): ______________________________________________________________________________________________________________________________________
I. Major Operations
Name of Signature of
Date of Name of Type of Name of Name of Qualified
No. Case No. Diagnosis Operation Performed Surgeon Qualified CI
Operation Patient Anesthesia Hospital CI
1. March 12, 2009 09000012280 Bautista, Clara Mature Senile Cataract Left Phacoemulsification with Posterior Monitored Dr. Jonathan Fatima Secinia I. Tallo RN,
Pedrosa Eye Chamber Intraocular Lens Left Eye Anesthesia Care Dominic Feliciano University RM, MAN
Medical Center
Fatima
2. March 19, 2009 090000123038 Gabito, Reynante Ruptured Appendix Appendectomy Spinal Dr. James Taclin Secinia I. Tallo RN,
University
Anesthesia Bañez RM, MAN
Medical Center
3. June 11, 2009 06080968 Imperial, Hilaria Mature Senile Cataract Right Phacoemulsification with Posterior Monitored Dr. Guillermo Loja Fatima Eye And Arvin A. Aculana RN,
Ponce Eye Chamber Intraocular Lens Right Anesthesia Care Rehabilitation MAN
Eye Center
Gravida 2 Para 1 Pregnancy
4. October 27, 2009 01021 Dionela, Annabel Uterine Full Term 37 Weeks Low Transverse Cesarian Section Spinal Dr. Emily Balagtas Doctors Wilowena Angeles RN,
Non And 5 Days Age of Gestation Anesthesia Fernando Hospital MAN
Not In Labor
5. October 27, 2009 01024 Pepito, Asuncion Mature Senile Cataract Right Cataract Extraction Right Eye Monitored Dr. Ronaldo Balagtas Wilowena Angeles RN,
Dagohoy Eye Anesthesia Care Fernando Doctors Hospital MAN
Prepared by: Noted by:

GARCIA, JAMIE LYNN C__________. Concurred by: Approved by:
MARISOL GARCIA – MANIPOL RN, MAN Concurred by:
Signature over printed Name of Student Signature over printed name of
MYLENE BERNADETTE O. SANTOS RN, MAN, MD NELIA R. CAPULONG RN, RM, MAN
Clinical Coordinator LORNA PUNONGBAYAN DIANO RN
Supervised by: Signature over printed name of Signature over printed Name of Dean
Date Signed: _____________________ Signature over printed name of
Chief Nurse Date Signed: ____________
_______________ Degree: BSN, MAN Chief Nurse
Date Signed: ___________ Degree: BSN, RM, MAN____
.
Signature over printed name of Faculty PRC NO: 0296870 Date Signed: ___________
Degree: _BSN, MD, MAN_____ a.) PRC NO: _0041904____
.
Date Signed: ____________ Valid Until: September 2012__ Degree: _RN______________

PRC NO: _0192913____ Valid Until: _July 31, 2012__
Degree: ________________ b.) PNA NO: ___________ PRC NO:0260345
Valid Until: _February 28, 2013_ .
b.) PNA NO: _18698_____
a.) PRC NO: __________ Valid Until:_________ Valid Until: _March 21, 2013
b.) PNA NO: ___________ Valid Until: _LIFETIME____
Valid Until: ________ Valid Until: _________ b.) PNA NO: ___________
ADPCN NO: _0627___
b.) PNA NO: _________ Valid Until: _________
Valid Until: __________
Valid Until: ___________
Name of Student: GARCIA, JAMIE LYNN CARTAGENA _ .
Year Graduated (BSN Program): ____________________________________________________________________________________________________________________________________________
I. Minor Operations
No. Signature of
Date of Case No. Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of Qualified CI Qualified CI
Operation Anesthesia
1. April 8, 2009 011245 Haban, Rondolf Phemosis Circumcision Local Dr. Jose Antonio Novaliches District Rosanie C. Moro RN,
Anesthesia Hospital PhD
2. April 16, 2009 1775519 De Lava, Hansley Abscess Left Frontal Incision And Drainage Dr. Libunao Novaliches District Rosanie C. Moro RN,
Area Hospital PhD
3.
4.
5.
GARCIA, JAMIE LYNN C__________. MARISOL GARCIA – MANIPOL RN, MAN Concurred by: Concurred by: Approved by:
Signature over printed Name of Student Signature over printed name of
Clinical Coordinator JOSEPHINE B. LEONARDO RN, PhD ___________________________ NELIA R. CAPULONG RN, RM, MAN
Supervised by: Date Signed: _____________________ Signature over printed name of Signature over printed name of Signature over printed Name of Dean
Degree: BSN, MAN .
Chief Nurse Chief Nurse Date Signed: ____________
_______________ PRC NO: 0296870 .
Date Signed: ___________ Date Signed: ___________ Degree: BSN, RM, MAN____
Signature over printed name of Faculty Valid Until: September 2012__ Degree:_BSN, MAN, PhD___ Degree:_______________ a.) PRC NO: _0041904____
Date Signed: ____________ b.) PNA NO: ___________ PRC NO: _0081174___ PRC NO: __________ Valid Until: _July 31, 2012__
Degree: ________________ Valid Until:_________ Valid Until: _April 3, 2013___ Valid Until: ____________ b.) PNA NO: _18698_____
a.) PRC NO: __________ b.) PNA NO: _15614___ b.) PNA NO: ___________ Valid Until: _LIFETIME____
Valid Until: ________ Valid Until: _LIFETIME____ Valid Until: _________ ADPCN NO: _0627___
b.) PNA NO: _________ Valid Until: __________

I. Actual Deliveries
Supervised by: Signature of
No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Qualified CI
Delivery Baby
1. 09-8329 Gravida 1 Para 0 Pregnancy Uterine Rosales, Jermanie 22 August 3, 2009 2:28 AM Girl San Jose District Hospital Forcep Delivery Rosalinda L. Flores RN, MAN
Full Term Cephalic In Labor Masangkay PRC NO: 0082223
PNA NO:
2. 421850 Gravida 1 Para 0 Pregnancy Uterine Sangalong, Jocelyn 20 September 16, 8:44 PM Girl Batangas Regional Normal Spontaneous Gonzala De Mesa RN, MAN
Full Term 39 Weeks and 4 Days Age Of 2009 Hospital Delivery
Gestation Cephalic In Labor
3. 421936 Gravida 4 Para 3 Pregnancy Uterine Magpantay, Maria 34 September 18, 9:16 PM Boy Batangas Regional Normal Spontaneous Gonzala De Mesa RN, MAN
Full Term 41 Weeks and 1 Day Age Of Carmina 2009 Hospital Delivery
Gravida 3 Para 2 Pregnancy Uterine

4. 422188 Full Term 38 Weeks and 1 Day Age Of Colis, Rodelyn 32 September 19, 12:38 AM Boy Batangas Regional Normal Spontaneous Gonzala De Mesa RN, MAN
Gestation Cephalic In Labor 2009 Hospital Delivery
5.
Year Graduated (BSN Program): _______________________________________________________________________________________ ________________ __________

Concurred by:
GARCIA, JAMIE LYNN C__________. MARISOL GARCIA – MANIPOL RN, MAN Concurred by: Approved by:
Signature over printed Name of Student Signature over printed name of AMOR CALAYAN RN, RM, MAN,PhD
Clinical Coordinator ROSALINDA L. FLORES RN, MAN Signature over printed name of NELIA R. CAPULONG RN, RM, MAN
Supervised by: Date Signed: _____________________ Signature over printed name of Chief Nurse Signature over printed Name of Dean
Degree: BSN, MAN .
Chief Nurse Date Signed: ___________ Date Signed: ____________
_______________ PRC NO: 0296870 .
Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ Degree: BSN, RM, MAN____
Signature over printed name of Faculty Valid Until: September 2012__ Degree:_BSN, MAN______ PRC NO: _151514___ a.) PRC NO: _0041904____
Date Signed: ____________ b.) PNA NO: ___________ PRC NO: _0082223_____ Valid Until: _August 2013____ Valid Until: _July 31, 2012__
Degree: ________________ Valid Until:_________ Valid Until: _November 25, 2011 b.) PNA NO: ___________ b.) PNA NO: _18698_____
a.) PRC NO: __________ b.) PNA NO: ___________ Valid Until: _________ Valid Until: _LIFETIME____
Valid Until: ________ Valid Until: _________ c.) ANSAP NO: ______________ ADPCN NO: _0627___
b.) PNA NO: _________ Valid Until:_______________ Valid Until: __________

Year Graduated (BSN Program): ___________________________________________________________ .
IV. Deliveries Assisted

No. Case No. Diagnosis Name of Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Supervised by: Signature of
Mother Delivery Baby Qualified C.I.
1.
08-3249 Gravida 1 Para 0 39 Weeks Age of Remo, 31 August 1, 2009 2:14 PM Boy San Jose District Hospital Normal Spontaneous Rosalinda L. Flores RN, MAN
Gestation Cephalic In Labor Rochelle Delivery PRC NO: 0082223
PNA NO:
2.
08-1610 Gravida 1, Para 0 Pregnancy Uterine Cuasay, 21 July 30, 2009 6:58 PM Boy San Jose District Hospital Normal Spontaneous Rosalinda L. Flores RN, MAN
37-38 Weeks Age Of Gestation Rose Ann Delivery PRC NO: 0082223
Cephalic In Labor PNA NO:
3.
Gravida 1, Para 0 Pregnancy Uterine
420394 Lacdang, 18 September 16, 8:05 AM Boy Batangas Regional Normal Spontaneous Gonzala De Mesa RN, MAN
38 Weeks and 2 Days Age Of
April 2009 Hospital Delivery
4.
5.

Concurred by:
GARCIA, JAMIE LYNN C__________. MARISOL GARCIA – MANIPOL RN, MAN Concurred by: Approved by:
Signature over printed Name of Student Signature over printed name of AMOR CALAYAN RN, RM, MAN,PhD
Clinical Coordinator ROSALINDA L. FLORES RN, MAN Signature over printed name of NELIA R. CAPULONG RN, RM, MAN
Supervised by: Date Signed: _____________________ Signature over printed name of Chief Nurse Signature over printed Name of Dean
Degree: BSN, MAN .
Chief Nurse Date Signed: ___________ Date Signed: ____________
_______________ PRC NO: 0296870 .
Date Signed: ___________ Degree:_ BSN, RM, MAN,PhD ___ Degree: BSN, RM, MAN____
Signature over printed name of Faculty Valid Until: September 2012__ Degree:_BSN, MAN______ PRC NO: _151514___ a.) PRC NO: _0041904____
Date Signed: ____________ b.) PNA NO: ___________ PRC NO: _0082223_____ Valid Until: _August 2013____ Valid Until: _July 31, 2012__
Degree: ________________ Valid Until:_________ Valid Until: _November 25, 2011 b.) PNA NO: ___________ b.) PNA NO: _18698_____
a.) PRC NO: __________ b.) PNA NO: ___________ Valid Until: _________ Valid Until: _LIFETIME____
Valid Until: ________ Valid Until: _________ c.) ANSAP NO: ______________ ADPCN NO: _0627___
b.) PNA NO: _________ Valid Until:_______________ Valid Until: __________

Year Graduated (BSN Program): ______________________________ .
V. Cord Dressing
No. Case No. Date Performed Name of Baby Gender of Name of Age Name of Hospital Supervised by: Signature of Qualified C.I.
Baby Mother
Rosalinda L. Flores RN, MAN
1. 09-10-466 July 31, 2009 Baby Boy Ocampo Boy Ocampo, Maricel 25 San Jose District Hospital PRC NO: 0082223
PNA NO:
2. 09-10-433 July 31, 2009 Baby Boy Liwanag Boy Liwanag, Maylin 20 San Jose District Hospital Rosalinda L. Flores RN, MAN
PRC NO: 0082223
PNA NO:
3.
4.
5.
Prepared by: Noted by: Concurred by: Concurred by: Approved by:
GARCIA, JAMIE LYNN C__________. MARISOL GARCIA – MANIPOL RN, MAN ROSALINDA L. FLORES RN, MAN ______________________________ NELIA R. CAPULONG RN, RM, MAN
Signature over printed Name of Student Signature over printed name of Signature over printed name of Signature over printed name of Signature over printed Name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Date Signed: ____________
Supervised by: Date Signed: _____________________ Date Signed: ___________ Date Signed: ___________ Degree: BSN, RM, MAN____
Degree: BSN, MAN Degree:_BSN, MAN______ Degree:_______________ a.) PRC NO: _0041904____
_______________
.
Signature over printed name of Faculty a.)_PRC NO: 0296870 .

b.) PRC NO: _0082223_____ a.) PRC NO: __________ Valid Until: _July 31, 2012__
Valid Until: September 2012__ Valid Until: _November 25, 2011 Valid Until: ____________ b.) PNA NO: _18698_____
Date Signed: ____________
b.) PNA NO: ___________ b.) PNA NO: ___________ b.) PNA NO: ___________ Valid Until: _LIFETIME____
Degree: ________________
Valid Until:_________ Valid Until: _________
a.) PRC NO: __________ Valid Until: _________ b.)ADPCN NO: _0627___
Valid Until: ________ Valid Until: __________
b.) PNA NO: _________

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Our Lady of Fatima University #1 Esperanza St. Hilltop Mansion

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OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City

Name of Student: GARCIA, JAMIE LYNN CARTAGENA .

Year of Admission in the Bachelor of Science in Nursing Program: 2004 .

Year Graduated (BSN Program): ______________________________________________________________________________________________________________________________________

Prepared by: Noted by:

Date Signed: ____________ Valid Until: September 2012__ Degree: _RN______________

Name of Student: GARCIA, JAMIE LYNN CARTAGENA _ .

Year of Admission in the Bachelor of Science in Nursing Program: 2004 .

Year Graduated (BSN Program): ____________________________________________________________________________________________________________________________________________