You are on page 1of 5

NUEVA ECIJA COLLEGES

(Formerly Nueva Ecija Colleges school of Nursing)
National Highway, Cabanatuan City
Tel no.: (044) 940 2191

Name of Student: TEJANO, CARINA BIANCA MIRANDA
Name and Address of School: NUEVA ECIJA COLLEGES, CAGAYAN VALLEY ROAD, CABANATUAN CITY, NUEVA ECIJA
Accreditation Level: NOT APPLICABLE Year Granted: NOT APPLICABLE
Date School / Program was recognized: July 17 Number: 071 Year: 1981
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: 2006 Year Graduated (BSN Program): 2010

I. MAJOR OPERATIONS
Date of
No. Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital
Operation

1

2

3

4

5

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JEREMIAH M. MASCARIÑAS MARILYN P. ABERGAS DR. AURORA R. CARBONELL
Signature over printed name of student Signature over printed name of Clinical Instructor Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, RM, MAN, PhD.
a) PRC NO. a) PRC NO. 0170960 a) PRC NO. a) PRC NO. 32010
Valid until Valid until August 22, 2012 Valid until Valid until September 2, 2011
b) PNA. b) PNA. 18780 b) PNA. b) PNA. 2642
Valid until Life Member Valid until Life Member Valid until Life Member
c) ANSAP NO. c) ADNCN NO. 223
Valid until Valid until 2010
NUEVA ECIJA COLLEGES
(Formerly Nueva Ecija Colleges school of Nursing)
National Highway, Cabanatuan City
Tel no.: (044) 940 2191
Name of Student: MASCARIÑAS, JEREMIAH MEJORADA
Name and Address of School: NUEVA ECIJA COLLEGES, CAGAYAN VALLEY ROAD, CABANATUAN CITY, NUEVA ECIJA
Accreditation Level: NOT APPLICABLE Year Granted: NOT APPLICABLE
Date School / Program was recognized: July 17 Number: 071 Year: 1981
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: 2006 Year Graduated (BSN Program): 2010

II. MINOR OPERATIONS
Date of
No. Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital
Operation

1

2

3

4

5

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JEREMIAH M. MASCARIÑAS MARILYN P. ABERGAS DR. AURORA R. CARBONELL
Signature over printed name of student Signature over printed name of Clinical Instructor Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, RM, MAN, PhD.
b) PRC NO. a) PRC NO. 0170960 a) PRC NO. a) PRC NO. 32010
Valid until Valid until August 22, 2012 Valid until Valid until September 2, 2011
b) PNA. b) PNA. 18780 b) PNA. b) PNA. 2642
Valid until Life Member Valid until Life Member Valid until Life Member
c) ANSAP NO. c) ADNCN NO. 223
Valid until Valid until 2010
NUEVA ECIJA COLLEGES
(Formerly Nueva Ecija Colleges school of Nursing)
National Highway, Cabanatuan City
Tel no.: (044) 940 2191

Name of Student: MASCARIÑAS, JEREMIAH MEJORADA
Name and Address of School: NUEVA ECIJA COLLEGES, CAGAYAN VALLEY ROAD, CABANATUAN CITY, NUEVA ECIJA
Accreditation Level: NOT APPLICABLE Year Granted: NOT APPLICABLE
Date School / Program was recognized: July 17 Number: 071 Year: 1981
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: 2006 Year Graduated (BSN Program): 2010

III. ACTUAL DELIVERIES
Date of Time of
No. Case No. Diagnosis Name of Mother Age Gender of Baby Name of Hospital Type of Delivery
Delivery Delivery

1

2

3

4

5

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JEREMIAH M. MASCARIÑAS MARILYN P. ABERGAS DR. AURORA R. CARBONELL
Signature over printed name of student Signature over printed name of Clinical Instructor Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, RM, MAN, PhD.
c) PRC NO. a) PRC NO. 0170960 a) PRC NO. a) PRC NO. 32010
Valid until Valid until August 22, 2012 Valid until Valid until September 2, 2011
b) PNA. b) PNA. 18780 b) PNA. b) PNA. 2642
Valid until Life Member Valid until Life Member Valid until Life Member
c) ANSAP NO. c) ADNCN NO. 223
Valid until Valid until 2010
NUEVA ECIJA COLLEGES
(Formerly Nueva Ecija Colleges school of Nursing)
National Highway, Cabanatuan City
Tel no.: (044) 940 2191

Name of Student: MASCARIÑAS, JEREMIAH MEJORADA
Name and Address of School: NUEVA ECIJA COLLEGES, CAGAYAN VALLEY ROAD, CABANATUAN CITY, NUEVA ECIJA
Accreditation Level: NOT APPLICABLE Year Granted: NOT APPLICABLE
Date School / Program was recognized: July 17 Number: 071 Year: 1981
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: 2006 Year Graduated (BSN Program): 2010

IV. DELIVERIES ASSISTED
Time of
No. Case No. Diagnosis Name of Mother Age Date of Delivery Gender of Baby Name of Hospital Type of Delivery
Delivery

1

2

3

4

5

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JEREMIAH M. MASCARIÑAS MARILYN P. ABERGAS DR. AURORA R. CARBONELL
Signature over printed name of student Signature over printed name of Clinical Instructor Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, RM, MAN, PhD.
d) PRC NO. a) PRC NO. 0170960 a) PRC NO. a) PRC NO. 32010
Valid until Valid until August 22, 2012 Valid until Valid until September 2, 2011
b) PNA. b) PNA. 18780 b) PNA. b) PNA. 2642
Valid until Life Member Valid until Life Member Valid until Life Member
c) ANSAP NO. c) ADNCN NO. 223
Valid until Valid until 2010
NUEVA ECIJA COLLEGES
(Formerly Nueva Ecija Colleges school of Nursing)
National Highway, Cabanatuan City
Tel no.: (044) 940 2191

Name of Student: MASCARIÑAS, JEREMIAH MEJORADA
Name and Address of School: NUEVA ECIJA COLLEGES, CAGAYAN VALLEY ROAD, CABANATUAN CITY, NUEVA ECIJA
Accreditation Level: NOT APPLICABLE Year Granted: NOT APPLICABLE
Date School / Program was recognized: July 17 Number: 071 Year: 1981
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: 2006 Year Graduated (BSN Program): 2010

V. CORD DRESSING
No. Case No. Date Performed Name of Baby Gender Name of Mother Age Name of Hospital

1

2

3

4

5

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JEREMIAH M. MASCARIÑAS MARILYN P. ABERGAS DR. AURORA R. CARBONELL
Signature over printed name of student Signature over printed name of Clinical Instructor Signature over printed name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Dean
Date Signed: Date Signed: Date Signed: Date Signed: Date Signed:
Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges Nueva Ecija Colleges
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, RM, MAN, PhD.
e) PRC NO. a) PRC NO. 0170960 a) PRC NO. a) PRC NO. 32010
Valid until Valid until August 22, 2012 Valid until Valid until September 2, 2011
b) PNA. b) PNA. 18780 b) PNA. b) PNA. 2642
Valid until Life Member Valid until Life Member Valid until Life Member
c) ANSAP NO. c) ADNCN NO. 223
Valid until Valid until 2010