Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.

(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com SURGICAL SCRUB (Major) in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ DATE PERFORMED AND TIME STARTED April 26, 2010 Time Started: 10:15 AM April 27, 2010 Time Started: 10:41 AM June 21, 2010 Time Started: 8:20 PM PATIENTS INITIALS (ONLY) CASE NUMBER C.D 46-42-19 K.A 46-56-93 J.C 32-57-43 SURGICAL PROCEDURE PERFORMED E/L TABHSOO, Adhesiolysis ORIF E repeat LSTCS with UTL O.R. NURSE ON DUTY (NAME AND SIGNATURE) SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mr. Erwin Dorego, RN, MAN Mr. Erwin Dorego, RN, MAN Mr. Erwin Dorego, RN, MAN

Ms. Angela Lagrera, RN Ms. Gina Pontejos, RN Ms. Delda Villarante, RN

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member Date document is signed: ___________Time___________ ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Management

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member Date document is signed: Highest Nursing Degree Earned: Doctor of

Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com SURGICAL SCRUB (Major) in Bethany Hospital, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ DATE PERFORMED AND TIME STARTED November 29, 2010 Time Started: 1:50 PM PATIENTS INITIALS (ONLY) CASE NUMBER R.A.D 25-50-20 SURGICAL PROCEDURE PERFORMED O.R. NURSE ON DUTY (NAME AND SIGNATURE) SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mr. Jeremy Astilla, RN, MAN

E 1 LSTCS

Ms. Rhodalyn Amor, RN

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member Date document is signed: ___________Time___________ ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Management

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member Date document is signed: Highest Nursing Degree Earned: Doctor of

Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com SURGICAL SCRUB (Minor) in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER M.D 44-73-86 G.G 51-90-90 L.A 45-73-35 F.B 47-83-17

DATE PERFORMED AND TIME STARTED December 6, 2010 Time Started: 3:46 PM May 8, 2011 Time Started: 10:09 AM May 9, 2011 Time Started: 11:44 PM July 7, 2010 Time Started: 9:50 AM

SURGICAL PROCEDURE PERFORMED Fractional curettage under IV sedation Completion Curettage Incision and Drainage of Labia majora with biopsy Excision of mass Left Deltoid area

O.R. NURSE ON DUTY (NAME AND SIGNATURE) Ms. Grace Gay Carrera, RN Ms. Roselle Catugda, RN Ms. Janice Cabutan, RN / Ms. Vilma Almaden, RN Mrs. Grace Brillo, RN

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mrs. Rebecca de Asis, RN, MAN Mrs. Rebecca de Asis, RN, MAN Mrs. Rebecca de Asis, RN, MAN Mrs. Evelyn Rances, RN, MHS

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM

Approved by:

DR. SOCORRO

Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013

Dean, PRC I.D No. 063136 Valid Until June

PNA No.5687 Valid Until: Life member PNA No. 1219 Valid Until: Life member Date document is signed: ___________Time___________ Date document is signed: ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Highest Nursing Degree Earned: Doctor of Management Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com SURGICAL SCRUB (Minor) in Remedios Trinidad Romualdez Hospital, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER J.L 00-00-64

DATE PERFORMED AND TIME STARTED May 20, 2011 Time Started: 10:30 AM

SURGICAL PROCEDURE PERFORMED Circumcision

O.R. NURSE ON DUTY (NAME AND SIGNATURE) Mr. Mario Yutangco, RN

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mrs. Asela C. Celestial, RM, RN, MAN

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member

Date document is signed: ___________Time___________ ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Management

Date document is signed: Highest Nursing Degree Earned: Doctor of

Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com ASSISTED DELIVERY in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER M.T 48-03-09 R.V 45-59-52 M.E 28-64-73

DATE PERFORMED AND TIME STARTED July 20, 2010 Time Started: 6:32 AM January 10, 2010 Time Started: 3:33 PM February 28, 2010 Time Started: 9:55 AM

PROCEDURE PERFORMED Assisted Delivery Assisted Delivery Assisted Delivery

D.R. NURSE ON DUTY (NAME AND SIGNATURE) Mrs. Rebecca Gorres, RN Mrs. Pamela Catilogo, RN Mrs. Rebecca Gorres, RN

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mr. Robert Agner, RN, MSN Mrs. Rebecca de Asis, RN, MAN Ms. Gina Capales, RN, MAN

May 24, 2010 Time Started: 6:07 AM September 20, 2010 Time Started: 12:05 PM

J.B 47-16-79 M.H.C 48-88-58

Assisted Delivery Assisted Delivery

Mrs. Alona Grothe, RN Mrs. Rebecca Gorres, RN

Mrs. Rebecca de Asis, RN, MAN Mrs. Rebecca de Asis, RN, MAN

Noted by: MRS. EVELYN U. RANCES, RN, MHS Approved by: DR. SOCORRO SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until Dean, PRC I.D No. 063136 Valid Until June 2013 PNA No.5687 Valid Until: Life member PNA No. 1219 Valid Until: Life member Date document is signed: ___________Time___________ Date document is signed: ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Highest Nursing Degree Earned: Doctor of Management Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com ACTUAL DELIVERY HANDLED in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER G.G 51-90-69 M.F.M 45-59-65

DATE PERFORMED AND TIME STARTED May 10, 2011 Time Started: 4:56 AM January 11, 2010 Time Started: 2:19 PM

PROCEDURE PERFORMED Handled Delivery Handled Delivery

D.R. NURSE ON DUTY (NAME AND SIGNATURE) Ms. Janice Cabutan, RN / Vilma Almaden, RN Mrs. Rebecca Gorres, RN

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mrs. Rebecca de Asis, RN, MAN Mrs. Rebecca de Asis, RN, MAN

May 23, 2010 Time Started: 9:32 PM December 5, 2010 Time Started: 2:04 PM

M.B 46-05-64 M.A 49-98-15

Handled Delivery Handled Delivery Handled Delivery

Mrs. Alona Grothe, RN Mrs. Rebecca Gorres, RN

Mrs. Rebecca de Asis, RN, MAN Mrs. Evelyn Rances, RN, MHS

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member Date document is signed: ___________Time___________ ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Management

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member Date document is signed: Highest Nursing Degree Earned: Doctor of

Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com IMMEDIATE NEWBORN CARE in Leyte Provincial Hospital, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER

DATE PERFORMED AND TIME STARTED

PROCEDURE PERFORMED

NICU NURSE ON DUTY (NAME AND SIGNATURE)

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE)

December 13, 2010 Time Started: 4:03 PM

G.G 11-70-63

Cord Dressing

Ms. Barbra Navidad, RN

Mr. Robert Agner, RN, MSN

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member Date document is signed: ___________Time___________ ___________Time___________ Highest Nursing Degree Earned: Master of Health Science Management

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member Date document is signed: Highest Nursing Degree Earned: Doctor of

Doa Remedios Trinidad Romualdez Medical Foundation Calanipawan Road, Calanipawan, Tacloban City 6500 Philippines Tel. Nos.(053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053) 327-5506/ 327-5004, E-mail address: rtr1980@yahoo.com IMMEDIATE NEWBORN CARE in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte

Prepared by: __JAN GIL F. BASINANG__ PATIENTS INITIALS (ONLY) CASE NUMBER G.B 51-86-49 G.L 1 44-93-09 B.C 46-79-28 G.C 50-26-03

DATE PERFORMED AND TIME STARTED May 2, 2011 Time Started: 5:31 PM November 15, 2009 Time Started: 9:24 AM April 19, 2010 Time Started: 6:56 PM December 20, 2010 Time Started: 11:21 PM

PROCEDURE PERFORMED Cord Dressing Cord Dressing Cord Dressing Cord Dressing

NICU NURSE ON DUTY (NAME AND SIGNATURE) Mrs. Elissa Sevilla, RN Mrs. Elissa Sevilla, RN Mrs. Anelia Fe Sia, RN Mrs. Lea Demetria, RN

SUPERVISED BY CLINICAL INSTRUCTOR (NAME AND SIGNATURE) Mrs. Jesusa Magno, RN, MAN Mrs. Jesusa Magno, RN, MAN Mrs. Jesusa Magno, RN, MAN Mrs. Eunice Arbis, RM, RN, MAN

Noted by: MRS. EVELYN U. RANCES, RN, MHS SALVACION GASCO, RN, MN, DM Clinical Coordinator, PRC I.D No.00063765 Valid Until 2013 PNA No.5687 Valid Until: Life member Date document is signed: ___________Time___________ ___________Time___________

Approved by:

DR. SOCORRO

Dean, PRC I.D No. 063136 Valid Until June PNA No. 1219 Valid Until: Life member Date document is signed:

Highest Nursing Degree Earned: Master of Health Science Management

Highest Nursing Degree Earned: Doctor of