Puting Kahoy, Silang, Cavite

P.O.Box 1834, Manila, 1099 Philippines

Tel. # (049) 5411211, Fax # (049) 5411228, Web-site: ​www.aup.edu.ph
Accredited by: Association of Christian Schools, Colleges and Universities Accrediting Agency, Inc./Federation of Accrediting Agencies of the Philippines
Level IV Re-accreditation Status
Re-accreditation Autonomous Status (October 2003-October 2008; March 2009-December 2015; April 1, 2016-May 31, 2019)

STA. ROSA COMMUNITY HOSPITAL, Sta. Rosa City, Laguna

ACTUAL DELIVERY​ in ____________________________________________________________________________________________
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student: ​ ​ANASTASYA GISHELLA RORONG

Date Performed and Patient’s Name D.R. Nurse on Duty SUPERVISED BY

Time Started Case Number PROCEDURE
(Name and Signature) Clinical Instructor
(not applicable for Birthing Homes Lying-in PERFORMED
(If Midwife on Duty, Signature not required) Name and Signature
Clinics/Homes)
November 18, 2018
7:30 AM J.C.S Normal Spontaneous Delivery
Marciana P. Debuton, RM Rhodie Mae Ephteen Manalo-Javier
185214 RN, MAN

November 21, 2018

12:10 PM G.B.B Normal Spontaneous Delivery
Eleonor D. Villajuan, RN, MAN Rhodie Mae Ephteen Manalo-Javier
185265 RN, MAN

Noted by: ____________​Jane L. Rodriguez RN, Dr.PH​____________________________
(Signature over printed name)
Clinical Coordinator, PRC I.D. NO. ___​0088995​______ Valid Until ___​April 29, 2020_​_​___
Date document is signed: ________________________ Time ____________________
Please specify Highest Nursing Degree Earned: ___​Doctor of Public Health​_​__________
Approved by: ______________​Susy A. Jael RN, Ph.D​_​__________________________
(Signature over printed name)
Dean, PRC I.D. No. ____​0182103​_​____ Valid Until __​February 12, 2020​__​ _____
Date document is signed: _______________ Time: ___________________________
Specify Highest Nursing Degree Earned: ____​Doctor of Philosophy in Nursing​_______