ANDRES BONIFACIO COLLEGE College Park, Dipolog City, Philippines Telephone No.(065) 212-9776/ Fax No.

(065) 212-9178 / web-site: www.abcollege.edu.ph

Name of Student: CHARLITO C. LUAB JR. SUMMARY OF MAJOR OPERATIONS ASSISTED (Scrub Nurse) Name Date of of Operation Case Patie No. and Diagnosis No. nts Time Initial Assisted (only) August 16, 2012 4:59 P.M. Pregnancy uterine full term 36 weeks age of gestation placenta previa

Operation Performed

Type of Anesthesia

Name of Surgeon

Name of Hospital

Name and Signature of O. R. Nurse

Supervised by: Name and Signature of C. I.

1.

03-2938

A. U.

Primary low segment transverse cesarean section with bilateral tubal ligation Pelvic laparotomy right salpingooophorectomy

Spinal Anesthesia

Dr. Norman G. Silao

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

2.

November 15, 2012 8:55 P.M.

03-7464

M. G.

Ectopic pregnancy

Spinal Anesthesia

Dr. Avenida Vista

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

3.

November 17, 2012 10:40 A.M.

03-3992

M. G.

Prolapsed submucous uterine myoma

Vaginal Myomectomy

General Anesthesia

Dr. Norman G. Silao

ZDSMC

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

ANDRES BONIFACIO COLLEGE College Park, Dipolog City, Philippines Telephone No.(065) 212-9776/ Fax No. (065) 212-9178 / web-site: www.abcollege.edu.ph Commission on Higher Education Region IX, Zamboanga Peninsula Government Recognition No. 002 Series of 2006 SURGICAL SCRUB in Zamboanga del Sur Medical Center, Pagadian City, Zamboanga del Sur Hospital/Municipality/City/Province

O. R. Form 1A O. R. SCRUB FORM Major

Prepared by: Printed Name with Signature of Student: CHARLITO C. LUAB JR. Patients Initial (only) SURGICAL PROCEDURE PERFORMED Case Number August 16, 2012 4:59 P.M. O. R. Nurse on Duty

Date Performed and Time Started

SUPERVISED BY: Clinical Instructor Name and Signature

A. U. 03-29-38

Primary low segment transverse cesarean section with bilateral tubal ligation

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

November 15, 2012 8:55 P.M. November 17, 2012 10:40 A.M.

M. G. 03-74-64

Pelvic laparotomy right salpingooophorectomy

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

M. G. 03-39-92

Vaginal Myomectomy

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

Noted by: SHARON B. CABIGAS, R.N., M.N. Clinical Coordinator, PRC I.D. No. 0349540 Valid Until: March 16, 2013 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Nursing

Approved by: EVELYN A. LUNA, R.N., MPH Dean, PRC I.D. No. 0082222 Valid Until: May 31, 2015 Date Document is signed: Time: _____________ Please Specify Highest Nursing Degree Earned: Master in Public Health

ANDRES BONIFACIO COLLEGE College Park, Dipolog City, Philippines Telephone No.(065) 212-9776/ Fax No. (065) 212-9178 / web-site: www.abcollege.edu.ph

Name of Student: CHARLITO C. LUAB JR. SUMMARY OF MAJOR OPERATIONS ASSISTED (Circulating Nurse) Name Date of of Operation Case Patien Operation No. and Diagnosis No. ts Performed Time Initial Assisted (only) May 22, 2012 11:42 A.M.

Type of Anesthesia

Name of Surgeon

Name of Hospital

Name and Signature of O. R. Nurse

Supervised by: Name and Signature of C. I.

1.

02-7917

R. C.

Cleft Palate

Cheiloplasty

Local Anesthesia

Dr. Joseph Acosta/D r. Aurito C. Ampong Dr. Eric Talens/ Dr. Al Jamiri Radjid Dr. Eric Talens/ Dr. Al Jamiri Radjid

ZDSMC

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

2.

May 22, 2012 6:40 P.M.

02-7863

P. B.

Anterior neck nodes with colloidal adenomatous goiter

Subtotal thyroidectomy

General Anesthesia

ZDSMC

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

3.

May 22, 2012 10:48 P.M.

02-7869

S. A.

Calculous Cholecystitis

Cholecystectomy

General Anesthesia

ZDSMC

Thelma M. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

ANDRES BONIFACIO COLLEGE College Park, Dipolog City, Philippines Telephone No.(065) 212-9776/ Fax No. (065) 212-9178 / web-site: www.abcollege.edu.ph Commission on Higher Education Region IX, Zamboanga Peninsula Government Recognition No. 002 Series of 2006 SURGICAL SCRUB in Zamboanga del Sur Medical Center, Pagadian City, Zamboanga del Sur Hospital/Municipality/City/Province

O. R. Form 1B O. R. CIRCULATING FORM

Prepared by: Printed Name with Signature of Student: CHARLITO C. LUAB JR. Patients Initial (only) SURGICAL PROCEDURE PERFORMED Case Number May 22, 2012 11:42 A.M. O. R. Nurse on Duty

Date Performed and Time Started

SUPERVISED BY: Clinical Instructor Name and Signature

R. C. 02-79-17

Cheiloplasty

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N

May 22, 2012 6:40 P.M.

P. B. 02-78-63

Subtotal thyroidectomy

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

May 22, 2012 10:48 P.M.

S. A. 02-78-69

Cholecystectomy

Thelma A. Apatan, R.N., M.N., MPA

Shmesani Marie A. Alavanza, BSN, R.N., M.N.

Noted by: SHARON B. CABIGAS, R.N., M.N. Clinical Coordinator, PRC I.D. No. 0349540 Valid Until: March 16, 2013 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Nursing

Approved by: EVELYN A. LUNA, R.N., MPH Dean, PRC I.D. No. 0082222 Valid Until: May 31, 2015 Date Document is signed: Time: Please Specify Highest Nursing Degree Earned: Master in Public Health