You are on page 1of 1

Republic of the Philippines Davao Oriental State College of Science and Technology Guang-guang, Dahican, Mati City,Davao Oriental

Institute of Nursing and Health Care Related Learning Experience Clearance Name:_______________ Level:_______________ Inclusive date of Assignment Concept No. of hours Agency Date of Clearance Semester:_______________ SY:_______________ Clinical Instructor signature Remarks

_________________ Student nurse

__________________ Clinical Coordinator

________________ Level Coordinator

__________________ Dean

You might also like