EMILIO AGUINALDO COLLEGE
College of Nursing and Midwifery
Name of Student : MAGBANUA, MARK KENNETH TUBO______________________________________________
Name & Address of School : Emilio Aguinaldo College-Manila / 1113-1117 San Marcelino cor. Gonzales St. Ermita, Manila__
Accreditation Level(if any) : _______________________ Year Granted:__________________________
Date School/Program was recognized : June 14, 1983 _______________________ Number: 136 Year: 1983_____________
First Course (if any) :__________ ________________________________________________________________ School Graduated From: ____Year: _____
Year of Admission in the Bachelor of Science in Nursing Program : 2004 _______________________
Year Graduated (BSN Program) : October 30, 2006 _______________________
I. MAJOR OPERATIONS
Operation Type Of Name Of Name Of O.R. Scrub Signature Of O.R.
No. Date Of Operation Case No. Name Of Patient Diagnosis Name Of Hospital
Performed Anesthesia Surgeon Nurse Scrub Nurse
Jesus Maniago,
Adelante ,Mario Chronic Calculus Lumbar
1 March 27, 2006 144136 Cholecystectomy M.D./Don Tianco, Tondo Medical Center Evalyn Quintin, R.N.
Linsangan Cholelithiasis Epidural
M.D.
Low Transverse
Arsenio, Ma. Caesarian Section I
2 March 27, 2006 144438 Footling Breech Spinal Lita Baculna, M.D. Tondo Medical Center Virginia Peralta,R.N.
Leonora Bilateral Tubal
Ligation
Age Of Low Transverse
Adelante, Lucia Gestation 40-41 Caesarian Section I Subarachnoid Regina Monica
3 March 28, 2006 144532 Tondo Medical Center Alicia Alejandro, R.N.
Simpuico Weeks Gravida Bilateral Tubal Block Garcia, M.D.
3 Parity 3 Ligation
Continuous Jesus Maniago,
Legarda, Zenaida Chronic Calculus
4 March 29, 2006 141628 Cholecystectomy Lumbar M.D./ Gerardo Tondo Medical Center Josefina Afos, R.N.
Franco Cholelithiasis
Epidural Javier, M.D.
Pelvic Lap Left
Salphingooophorocy
Pelvic Continuous
Reyes, Ana stectomy Rhoda Juson, Larena Hernandez,
5 March 31, 2006 143942 Endometriosis Lumbar Tondo Medical Center
Angelica Right Adhesiolysis, M.D. R.N.
Gravida 1 Para 0 Epidural
Coagulation of
Endometria
Signed by:
______JOANN P. BUMANGLAG, RN, MAN______ RHODORA D. QUILANTIP, RN, MAN__________ ____MA. CATALINA C. MALLARY, RN, MAN____
Signature Over Printed name Of Overall Clinical Coordinator Signature Over Printed Name Of Chief Nurse Signature Over Printed Name Of the Dean
Of Tondo Medical Center
Date Signed : _
Degree :Bachelor of Science In Nursing Date Signed : Date Signed : _
Master of Arts in Nursing _ Degree : Bachelor of Science In Nursing Degree : Bachelor of Science In Nursing
a. PRC No. :0239004 _ Master of Arts in Nursing ________ Master of Arts in Nursing _
Valid Until :July 3, 2008___ _________ a. PRC No. : 0097511 a. PRC No. : 0068800 _________
b. PNA No. :31243 _ Valid Until: July 8, 2009______ ________ Valid Until: November 25, 2006 _
Valid Until :December 2006 _ b. PNA No. : 34152 b. PNA No. : 5537 _
Valid Until: December 31, 2006___________ Valid Until: Lifetime Member _________
C. ADPCN No. : 0589 _
Valid Until: 2007 _________
EMILIO AGUINALDO COLLEGE
College of Nursing and Midwifery
Name of Student : MAGBANUA, MARK KENNETH TUBO______________________________________________
Name & Address of School : Emilio Aguinaldo College-Manila / 1113-1117 San Marcelino cor. Gonzales St. Ermita, Manila__
Accreditation Level(if any) : _______________________ Year Granted:__________________________
Date School/Program was recognized : June 14, 1983 _______________________ Number: 136 Year: 1983_____________
First Course (if any) :__________ ________________________________________________________________ School Graduated From: ____Year: _____
Year of Admission in the Bachelor of Science in Nursing Program : 2004 _______________________
Year Graduated (BSN Program) : October 30, 2006 _______________________
II. MINOR OPERATIONS
Operation Type Of Name Of O.R. Scrub Signature of O.R.
No. Date Of Operation Case No. Name Of Patient Diagnosis Name Of Surgeon Name Of Hospital
Performed Anesthesia Nurse Scrub Nurse
Lateral Tube
Gerardo Javier,
1 March 26, 2006 144317 Velasco, Abelgardo Stab Wound Thoracostomy Local Tondo Medical Center Joel Aquino, R.N.
M.D.
Right
Inguinal Hernia Kiddie
2 March 27, 2006 138921 Bruma, Dave Andrei Herniotomy Don Tianco, M.D. Tondo Medical Center Evalyn Quintin, R.N.
Right Nynus Caudal
Sebaceous
Sanchez, Edward Gerardo Javier,
3 March 29, 2006 144614 Cyst Posterior Excision Local Tondo Medical Center Larena Hernandez, R.N.
Abiola M.D.
Neck Left
Rebutas, Cenon Mass Posterior
4 April 2, 2006 141376 Excision, Biopsy Axilla block Albert Dy, M.D. Tondo Medical Center Evalyn Quintin, R.N.
Relon Anterior Right
Disarticulation Traumatic
Manuel Aquino,
5 April 3, 2006 114768 Manalastas, Antonio 5th Digit Right Amputation Local Tondo Medical Center Paul Sevilla, R.N.
M.D.
Foot Right Foot
Signed by:
______JOANN P. BUMANGLAG, RN, MAN______ RHODORA D. QUILANTIP, RN, MAN__________ ____MA. CATALINA C. MALLARY, RN, MAN____
Signature Over Printed name Of Overall Clinical Coordinator Signature Over Printed Name Of Chief Nurse Signature Over Printed Name Of the Dean
Of Tondo Medical Center
Date Signed : _
Degree :Bachelor of Science In Nursing Date Signed : Date Signed : _
Master of Arts in Nursing _ Degree : Bachelor of Science In Nursing Degree : Bachelor of Science In Nursing
a. PRC No. :0239004 _ Master of Arts in Nursing ________ Master of Arts in Nursing _
Valid Until :July 3, 2008___ _________ a. PRC No. : 0097511 a. PRC No. : 0068800 _________
b. PNA No. :31243 _ Valid Until: July 8, 2009______ ________ Valid Until: November 25, 2006 _
Valid Until :December 2006 _ b. PNA No. : 34152 b. PNA No. : 5537 _
Valid Until: December 31, 2006___________ Valid Until: Lifetime Member _________
C. ADPCN No. : 0589 _
Valid Until: 2007 _________
EMILIO AGUINALDO COLLEGE
College of Nursing and Midwifery
Name of Student : MAGBANUA, MARK KENNETH TUBO______________________________________________
Name & Address of School : Emilio Aguinaldo College-Manila / 1113-1117 San Marcelino cor. Gonzales St. Ermita, Manila__
Accreditation Level(if any) : _______________________ Year Granted:__________________________
Date School/Program was recognized : June 14, 1983 _______________________ Number: 136 Year: 1983_____________
First Course (if any) :__________ ________________________________________________________________ School Graduated From: ____Year: _____
Year of Admission in the Bachelor of Science in Nursing Program : 2004 _______________________
Year Graduated (BSN Program) : October 30, 2006 _______________________
III. ACTUAL DELIVERIES
Time Of Gender Type Of Supervised by:
No. Case No. Diagnosis Name Of Patient Age Date Of Delivery Name Of Hospital
Delivery Of Baby Delivery (Name & Signature of Qualified C.I.)
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
1 7247 Aban, Athenas G. 26 November 25, 2005 8:23 am Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida2 Para2 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
2 7249 Valderama, Marilou P. 34 November 25, 2005 2:00pm Male Spontaneous Imelda M. Sales, RN,RM
Term Gravida3 Para3 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
3 7251 Topio, Rowena Z. 27 November 27, 2005 9:03 am Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida2 Para2 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine Full Lying-In Clinic, Barangay
4 7253 Dortes, Jasmin M. 25 November 29, 2005 1:45 am Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida3 Para3 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
5 7257 Roga, Deralyn R 25 November 30, 2005 7:29 pm Male Spontaneous Imelda M. Sales, RN,RM
Term Gravida 3 Para3 Guadalupe Nuevo, Makati
Delivery
City
Signed by:
______JOANN P. BUMANGLAG, RN, MAN______ ____MA. CATALINA C. MALLARY, RN, MAN____ _____________________________________________
Signature Over Printed name Of Overall Clinical CoordinatorSignature Over Printed Name Of the Dean Signature Over Printed name Of Physician In Charge Of
Primary Health Care and Lying-In Clinic, Guadalupe Nuevo,
Date Signed : _ Makati City
Degree :Bachelor of Science In Nursing Date Signed : _
Master of Arts in Nursing _ Degree : Bachelor of Science In Nursing Date Signed :____________________________
a. PRC No. :0239004 _ Master of Arts in Nursing _
Valid Until :July 3, 2008___ _________ a. PRC No. : 0068800 _________
b. PNA No. :31243 _ Valid Until: November 25, 2006 _
Valid Until :December 2006 _ b. PNA No. : 5537 _
Valid Until: Lifetime Member _________
C. ADPCN No. : 0589 _
Valid Until: 2007 _________
EMILIO AGUINALDO COLLEGE
College of Nursing and Midwifery
Name of Student : MAGBANUA, MARK KENNETH TUBO______________________________________________
Name & Address of School : Emilio Aguinaldo College-Manila / 1113-1117 San Marcelino cor. Gonzales St. Ermita, Manila__
Accreditation Level(if any) : _______________________ Year Granted:__________________________
Date School/Program was recognized : June 14, 1983 _______________________ Number: 136 Year: 1983_____________
First Course (if any) :__________ ________________________________________________________________ School Graduated From: ____Year: _____
Year of Admission in the Bachelor of Science in Nursing Program : 2004 _______________________
Year Graduated (BSN Program) : October 30, 2006 _______________________
IV. DELIVERIES ASSISTED
Time Of Gender Type pf Supervised by:
No. Case No. Diagnosis Name Of Mother Age Date Of Delivery Name Of Hospital
Delivery Of Baby Delivery (Name & Signature of Qualified C.I.)
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
1 7255 Busa-ing, Rubie S. 18 November 29, 2005 8:15 pm Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida1 Para1 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
2 7259 Redoble, Juvy S.. 25 December 1, 2005 12:01 pm Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida2 Para2 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
3 7261 Princesa, Digna S. 38 December 3, 2005 6:00 am Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida5 Para5 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
4 7269 Esmero, Jeralyn T. 28 December 4, 2005 1:34 am Female Spontaneous Imelda M. Sales, RN,RM
Term Gravida1 Para1 Guadalupe Nuevo, Makati
Delivery
City
Primary Health Care and
Normal
Pregnancy Uterine, Full Lying-In Clinic, Barangay
5 7265 Bisnar, Eufemia C. 25 December 5, 2005 2:08 am Male Spontaneous Imelda M. Sales, RN,RM
Term Gravida4 Para3 Guadalupe Nuevo, Makati
Delivery
City
Signed by:
______JOANN P. BUMANGLAG, RN, MAN______ ____MA. CATALINA C. MALLARY, RN, MAN____ _____________________________________________
Signature Over Printed name Of Overall Clinical Signature Over Printed Name Of the Dean Signature Over Printed name Of Physician In Charge Of
Coordinator Primary Health Care and Lying-In Clinic, Guadalupe Nuevo,
Makati City
Date Signed : _ Date Signed : _
Degree :Bachelor of Science In Nursing Degree : Bachelor of Science In Nursing Date Signed:____________________________
Master of Arts in Nursing _ Master of Arts in Nursing _
a. PRC No. :0239004 _ a. PRC No. : 0068800 _________
Valid Until :July 3, 2008___ _________ Valid Until: November 25, 2006 _
b. PNA No. :31243 _ b. PNA No. : 5537 _
Valid Until :December 2006 _ Valid Until: Lifetime Member _________
C. ADPCN No. : 0589 _
Valid Until: 2007 _________
EMILIO AGUINALDO COLLEGE
College of Nursing and Midwifery
Name of Student : MAGBANUA, MARK KENNETH TUBO______________________________________________
Name & Address of School : Emilio Aguinaldo College-Manila / 1113-1117 San Marcelino cor. Gonzales St. Ermita, Manila__
Accreditation Level(if any) : _______________________ Year Granted:__________________________
Date School/Program was recognized : June 14, 1983 _______________________ Number: 136 Year: 1983_____________
First Course (if any) :__________ ________________________________________________________________ School Graduated From: ____Year: _____
Year of Admission in the Bachelor of Science in Nursing Program : 2004 _______________________
Year Graduated (BSN Program) : October 30, 2006 _______________________
V. CORD DRESSING
Supervised by:
No. Case No. Date Performed Name Of Baby Gender Of Baby Age Of Baby Name Of Mother Age Of Mother Name Of Hospital (Name & Signature of Qualified
C.I.)
Baby Boy Crisostomo, Aisa Primary Health Care and Lying-In
1 7238 November 23, 2005 Male Newborn 18 Imelda M. Sales, RN,RM
Crisostomo Namia Clinic, Guadalupe Nuevo, Makati City
Primary Health Care and Lying-In
2 7239 November 23, 2005 Baby Girl Alfaro Female Newborn Alfaro, Divina D. 21 Imelda M. Sales, RN,RM
Clinic, Guadalupe Nuevo, Makati City
Primary Health Care and Lying-In
3 7240 November 24, 2005 Baby Boy Palen Male Newborn Palen, Emelyn P. 22 Imelda M. Sales, RN,RM
Clinic, Guadalupe Nuevo, Makati City
Baby Boy Primary Health Care and Lying-In
4 7241 November 24, 2005 Male Newborn Labargo, Emelyn P. 21 Imelda M. Sales, RN,RM
Labargo Clinic, Guadalupe Nuevo, Makati City
Primary Health Care and Lying-In
5 7242 November 24, 2005 Baby Boy Hidalgo Male Newborn Ramos, Meryll T. 26 Imelda M. Sales, RN,RM
Clinic, Guadalupe Nuevo, Makati City
Signed by:
____ JOANN P. BUMANGLAG, RN, MAN_______ ____MA. CATALINA C. MALLARY, RN, MAN____ _____________________________________________
Signature Over Printed name Of Overall Clinical Coordinator Signature Over Printed Name Of the Dean Signature Over Printed name Of Physician In Charge Of
Primary Health Care and Lying-In Clinic, Guadalupe Nuevo,
Date Signed : _ Makati City
Degree :Bachelor of Science In Nursing Date Signed : _
Master of Arts in Nursing _ Degree : Bachelor of Science In Nursing Date Signed:____________________________
a. PRC No. :0239004 _ Master of Arts in Nursing _
Valid Until :July 3, 2008___ _________ a. PRC No. : 0068800 _________
b. PNA No. :31243 _ Valid Until: November 25, 2006 _
Valid Until :December 2006 _ b. PNA No. : 5537 _
Valid Until: Lifetime Member _________
C. ADPCN No. : 0589 _
Valid Until: 2007 _________