case format haha

7/28/2019 Case Format haha

1/5

CALAMBA DOCTORS COLLEGENational Highway Brgy. Parian Calamba City,Laguna

Tel.Nos.(049)545-9921 to 22Name of Student: LA TORRE, DORCAS OBANDO_______________________________________________

Name and Address of School: Calamba Doctors College/National Highway Brgy. Parian Calamba City LagunaAccreditation Level: (if any)_____________________________________Year Granted:__________________________

Date/School Program was Recognized: DECEMBER 22,2005___Number:094______ Year: 2005____________________First Course (if any)____________________________School Graduated From_____________________Year_________

Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2008__________________________________Year Graduated(BSN Program): APRIL 2012____________________________________________________________

I.Ma

jor Operations

No. CaseNo.

Date ofOperation

Name of Patient Diagnosis OperationPerformed

Type ofAnesthes

ia

Name ofSurgeon

Name ofHospital

Name of O.RScrub Nurse

Signof ScNu

1 1044174

August 31,2010

Reynaldo ValenciaCordovez

Transected AchillesTendon Left

Repair of TransectedAchilles Tendon Left

Spinal Miguel CamposM.D

CalambaDoctorsHospital

Arlyn LozantaR.N

Noted by: Noted by: Approved by:

ARCELIE F. ALPAY, R.N., R.M., M.A.N. AURORA R. SAMOSA, R.N., M.A.N. LEA BELEN U. MOLABOLA-SANTILLAN, R.N., M.ASignature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of DeanDate signed: Date Signed: Date Signed: :Degree BSN, RM, MAN Degree: BSN MAN Degree BSN-MANPRC No: 0098060 PRC No: 0221517 PRC No: 0045357Valid until: June 30, 2012 Valid until: September 25, 20012 Valid until March 23, 2013PNA No: 16970 PNA No: 18688 PNA No:

Valid until: Lifetime Valid until: Lifetime Valid until: _______________ADCPN No: _11-272

________Valid until: ___2014________


2/5





Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2008__________________________________Year Graduated(BSN Program): APRIL 2012____________________________________________________________

I.M

inor Operations

No. CaseNo.

Date ofOperation

Name of Patient Diagnosis OperationPerformed

Type ofAnesthes

ia

Name ofSurgeon

Name ofHospital

Name of O.RScrub Nurse

Signof ScNu


ARCELIE F. ALPAY, R.N., R.M., M.A.N. AURORA R. SAMOSA, R.N., M.A.N. LEA BELEN U. MOLABOLA-SANTILLAN, R.N., M.ASignature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of DeanDate signed: Date Signed: Date Signed: :Degree BSN, RM, MAN Degree: BSN MAN Degree BSN-MANPRC No: 0098060 PRC No: 0221517 PRC No: 0045357Valid until: June 30, 2012 Valid until: September 25, 20012 Valid until March 23, 2013PNA No: 16970 PNA No: 18688 PNA No: ______________Valid until: Lifetime Valid until: Lifetime Valid until: _______________

ADCPN No: _11-272

________Valid until: __2014

_________


3/5





Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2008__________________________________

Year Graduated(BSN Program): APRIL 2012____________________________________________________________

III. Actual Deliveries

No.

Case No. Name of Patient Age Diagnosis Date of Delivery

Time ofDelivery

Gender ofBaby

Name ofHospital

Type ofDelivery

Supervised BName and Signa

of Qualified C

1 00000001 Dulce Dimagiba 41Pregnancy Uterine 39

40 weeks Age ofGestation Cephalic in

LaborGravida 9 Para7

Abortion 1 (8018)

January 1,2012

1:30 AM Female CalambaDoctorsCollege

NormalSpontaneous

Vaginal DeliveryAurora Samosa ,

M.A.N

2

3

Noted by Noted by: Approved by:

ARCELIE F. ALPAY, R.N., R.M., M.A.N. AURORA R. SAMOSA, R.N., M.A.N. LEA BELEN U. MOLABOLA-SANTILLAN, R.N., M.ASignature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of DeanDate signed: Date Signed: Date Signed: :Degree BSN, RM, MAN Degree: BSN MAN Degree BSN-MAN

PRC No: 0098060 PRC No: 0221517 PRC No: 0045357Valid until: June 30, 2012 Valid until: September 25, 20012 Valid until March 23, 2013

PNA No: 16970 PNA No: 18688 PNA No:Valid until: Lifetime Valid until: Lifetime Valid until: _______________

ADCPN No: __11-272

_____Valid until: ____2014

______


4/5







IV. Ass

isted Deliveries

No.

Case No. Name of Patient Age Diagnosis Date of Delivery

Time ofDelivery

Gender ofBaby

Name ofHospital

Type ofDelivery

Supervised Name and Sign

of Qualified

1 02100210 Leah Gascon 33Pregnancy Uterine 39

40 weeks Age ofGestation Cephalic in

LaborGravida 2 Para1 (2001)

December 31,2001

11:59 PM Male CalambaDoctorsCollege

NormalSpontaneous

Vaginal Delivery

Aurora SamosaM.A.N

2

3


ARCELIE F. ALPAY, R.N., R.M., M.A.N. AURORA R. SAMOSA, R.N., M.A.N. LEA BELEN U. MOLABOLA-SANTILLAN, R.N., M.ASignature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of DeanDate signed: Date Signed: Date Signed: :Degree BSN, RM, MAN Degree: BSN MAN Degree BSN-MANPRC No: 0098060 PRC No: 0221517 PRC No: 0045357Valid until: June 30, 2012 Valid until: September 25, 20012 Valid until March 23, 2013

PNA No: 16970 PNA No: 18688 PNA No:Valid until: Lifetime Valid until: Lifetime Valid until: _______________ADCPN No: ___11-272

_____Valid until: ___2014________


5/5







V. Cord Dressing

No.

Case No. Date Performed Name of Baby Genderof Baby

Name of Mother Age Name of Hospital

Supervised By:Name and Signature o

Qualified C.I.

1 0001021050411

May 4, 2011 Baby Dela Cruz Male Maria Dela Cruz 33 Calamba DoctorsHospital

Aurora Samosa , R.N, M

2

3


ARCELIE F. ALPAY, R.N., R.M., M.A.N. AURORA R. SAMOSA, R.N., M.A.N. LEA BELEN U. MOLABOLA-SANTILLAN, R.N., M.ASignature over Printed Name of Chief Nurse Signature over Printed Name of Clinical Coordinator Signature over Printed Name of DeanDate signed: Date Signed: Date Signed: :Degree BSN, RM, MAN Degree: BSN MAN Degree BSN-MANPRC No: 0098060 PRC No: 0221517 PRC No: 0045357Valid until: June 30, 2012 Valid until: September 25, 20012 Valid until March 23, 2013PNA No: 16970 PNA No: 18688 PNA No: 2012-032073Valid until: Lifetime Valid until: Lifetime Valid until: _______________

ADCPN No: ___11-272____

Valid until: ___2014_______

case format haha

Documents