WORK FROM HOME OUTPUT MONITORING FORM

(Appendix A)

Period Covered: February 09, 2024

Name of Employee: Ferdinand Garcia, RN ` Status: Part Time | X Full Time

Department: Nursing Date Submitted: February 09, 2024

Inclusive Dates Task(s) Status of Remarks

and Time Expected Output(s) Accomplishment (To be filled
(Please align to each task) (Indicate whether out
Accomplished, by Immediate
Partially Supervisor)
Accomplished,
Deferred)
February 09, 2023
8:00 – 12:00 nn Accomplished
Friday

February 09, 2023

1:00 – 5:00 pm

Accomplished

Other Accomplishments:
Prepared by: Verified and Checked aby: Noted by:

____ ______________ ____________________________ ________________

Employee’s Signature Raymundo S. Espino – Nursing Admin Academic Officer