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University of Pangasinan

College of Nursing

Name: _________________________________ Student Number: 07-2409


Date Started in BSN Program: ______________
Date Graduated from BSN Program: __________
University Seal

CLINICAL ROTATION

SY-2007-2008
Course Year Month Department or Area Name of Clinical
No. Hospital Agency of Instructor
Assignment
Health 2007 June- Classroom
Care I October Nursing Laboratory Instruction
(Return Demonstration)
Health 2007 November- City Health Office, Dagupan Public Health
Care I March City Nursing

1st Semester SY-2008-2009


Course Year Month Department or Area Name of Clinical
No. Hospital Agency of Instructor
Assignment
2008 June
2008 July
NCM
101
2008 August

2008 September

2nd Semester SY-2008-2009


Course Year Month Department or Area Name of Clinical
No. Hospital Agency of Instructor
Assignment
2008 November
2008 December
NCM
102
2009 January

2009 February
2009 March

Summer 2009
Course Year Month Department or Area Name of Clinical
No. Hospital Agency of Instructor
Assignment
2009 April
NCM
103 2009 May

Affiliation Summer 2009


Inclusive Hospital Agency Department or Area of Name of Clinical
Dates Assignment Instructor
National Centrum for Mental Health

Philippine Orthopedic Center

San Lazaro Hospital

Tahanan Walang Hagdan

Dr. Jose Rodriguez Memorial Hospital (TALA)

Presented to: Approved by: Noted by:


Julius S. Tempra Jona G. Agatarap Josefina C. Mangaliag
RLE III Team Leader RLE III Coordinator Level III Coordinator

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