ANDRES BONIFACIO COLLEGE College Park, Dipolog City, Philippines Telephone No.(065) 212-9776/ Fax No.

(065) 212-9178 / web-site: www.abcollege.edu.ph

Name of Student: CHARLITO C. LUAB JR. SUMMARY OF MAJOR OPERATIONS ASSISTED (Scrub Nurse) Name Date of of Operation Case Patie No. and Diagnosis No. nt’s Time Initial Assisted (only) August 16, 2012 4:59 P.M. Pregnancy uterine full term 36 weeks age of gestation placenta previa

Operation Performed

Type of Anesthesia

Name of Surgeon

Name of Hospital

Name and Signature of O. R. Nurse

Supervised by: Name and Signature of C. I.

1.

03-2938

A. U.

Primary low segment transverse cesarean section with bilateral tubal ligation Pelvic laparotomy right salpingooophorectomy

Spinal Anesthesia

Dr. Norman G. Silao

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

2.

November 15, 2012 8:55 P.M.

03-7464

M. G.

Ectopic pregnancy

Spinal Anesthesia

Dr. Avenida Vista

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

3.

November 17, 2012 10:40 A.M.

03-3992

M. G.

Prolapsed submucous uterine myoma

Vaginal Myomectomy

General Anesthesia

Dr. Norman G. Silao

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

..(065) 212-9776/ Fax No.. M. No. G. Zamboanga Peninsula Government Recognition No. R.N. 03-39-92 Vaginal Myomectomy Thelma M. 0349540 Valid Until: March 16.abcollege. 002 Series of 2006 SURGICAL SCRUB in Zamboanga del Sur Medical Center. Noted by: SHARON B.N. MPA Shmesani Marie A. G.N. MPH Dean.ANDRES BONIFACIO COLLEGE College Park.. MPA Shmesani Marie A. O.N. 0082222 Valid Until: May 31. Apatan.N.N. M. M. M. SCRUB FORM Major Prepared by: Printed Name with Signature of Student: CHARLITO C. No. R. Alavanza.N. Zamboanga del Sur Hospital/Municipality/City/Province O. R.N. M. 2012 4:59 P. LUAB JR. 03-29-38 Primary low segment transverse cesarean section with bilateral tubal ligation Thelma M.N. PRC I.N. BSN. 03-74-64 Pelvic laparotomy right salpingooophorectomy Thelma M. BSN.N. R.N. R.D. M. M.ph Commission on Higher Education Region IX. M.. LUNA. Apatan... MPA Shmesani Marie A.M.edu.N.. CABIGAS.N. Pagadian City. Alavanza. Patient’s Initial (only) SURGICAL PROCEDURE PERFORMED Case Number August 16. R. Form 1A O.M. R.N. Alavanza. BSN. PRC I. R.. R. November 17. 2012 8:55 P.D. Philippines Telephone No.. R. Dipolog City. 2015 Date Document is signed: Time: _____________ Please Specify Highest Nursing Degree Earned: Master in Public Health . U. R.. M. Clinical Coordinator.M. (065) 212-9178 / web-site: www. Apatan. Nurse on Duty Date Performed and Time Started SUPERVISED BY: Clinical Instructor Name and Signature A. 2013 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Nursing Approved by: EVELYN A. November 15. 2012 10:40 A.

Al Jamiri Radjid ZDSMC Thelma M.N. R.. BSN.N. B. R. R.abcollege. Anterior neck nodes with colloidal adenomatous goiter Subtotal thyroidectomy General Anesthesia ZDSMC Thelma M. BSN. Type of Anesthesia Name of Surgeon Name of Hospital Name and Signature of O. Ampong Dr. . Alavanza.N.. Apatan.N. May 22.N. R.N.M. C. 2. Aurito C.. LUAB JR.M.N.M. M.N. 02-7863 P. MPA Shmesani Marie A. BSN.edu.N.N. M.ph Name of Student: CHARLITO C.. 02-7917 R.(065) 212-9776/ Fax No.. R. M. and Diagnosis No. M. Joseph Acosta/D r. M. 1. M. Al Jamiri Radjid Dr. 2012 6:40 P. Eric Talens/ Dr.N. SUMMARY OF MAJOR OPERATIONS ASSISTED (Circulating Nurse) Name Date of of Operation Case Patien Operation No. 2012 10:48 P. R. Philippines Telephone No. t’s Performed Time Initial Assisted (only) May 22... Alavanza. MPA Shmesani Marie A.N. MPA Shmesani Marie A.ANDRES BONIFACIO COLLEGE College Park. 02-7869 S. (065) 212-9178 / web-site: www. A. Eric Talens/ Dr. 2012 11:42 A. 3. Dipolog City. Apatan. Calculous Cholecystitis Cholecystectomy General Anesthesia ZDSMC Thelma M.. Cleft Palate Cheiloplasty Local Anesthesia Dr.. R. May 22. Nurse Supervised by: Name and Signature of C. Apatan. I. Alavanza.

N.. No. Apatan. M.N May 22. LUNA. R.. Noted by: SHARON B. Form 1B O. No. O.N.N. Clinical Coordinator. M. R. MPA Shmesani Marie A. R.M.N.N. R. M. R. 0082222 Valid Until: May 31. R. BSN. 002 Series of 2006 SURGICAL SCRUB in Zamboanga del Sur Medical Center.abcollege... (065) 212-9178 / web-site: www. Zamboanga Peninsula Government Recognition No. C. 02-78-63 Subtotal thyroidectomy Thelma A.N. BSN.edu. 2015 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Public Health .M. M. May 22.N. P. BSN.N.. 0349540 Valid Until: March 16. M. Alavanza. MPH Dean. PRC I.N.D. Zamboanga del Sur Hospital/Municipality/City/Province O. 2012 11:42 A.ANDRES BONIFACIO COLLEGE College Park. 2012 6:40 P. 02-78-69 Cholecystectomy Thelma A.. LUAB JR. Dipolog City. Nurse on Duty Date Performed and Time Started SUPERVISED BY: Clinical Instructor Name and Signature R. S. 2013 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Nursing Approved by: EVELYN A. PRC I. 2012 10:48 P... M. Alavanza. Alavanza. Patient’s Initial (only) SURGICAL PROCEDURE PERFORMED Case Number May 22. R. B.. 02-79-17 Cheiloplasty Thelma A. MPA Shmesani Marie A.M.N..D. Apatan. R.N. CIRCULATING FORM Prepared by: Printed Name with Signature of Student: CHARLITO C. Philippines Telephone No. MPA Shmesani Marie A. Apatan.N. R.(065) 212-9776/ Fax No. CABIGAS. M. R. R. A. Pagadian City..ph Commission on Higher Education Region IX.N.N.

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