Mindanao Sanitarium & Hospital College

Brgy. San Miguel, Iligan City 9200

Name of the Student: Jiezlliza N. Encabo

Name & Address of School: Mindanao Sanitarium and Hospital College, Barangay San Miguel, Iligan City School code: 1362________________________________________
Accreditation Level: Level 1 Year Granted: February 28, 2008
Date School Program was Recognized: October 17, 2002 Number: 0043 Year: 2002
First Course (If any): N/A_________________________________________ School Graduated From: N/A____________________ Year: N/A ____
Year of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated from the BSN Program: 2010

I. MAJOR OPERATIONS

Signature of
Type of
NO. Date of Operation Case No. Name of Patient Diagnosis Operation Performed Name of Surgeon Name of Hospital Name of O.R. Scrub Nurse O.R. Scrub
Anesthesia
Nurse
Gunshot Wound Right Side
Abdomen with Exit at Mid- Mindanao
1 July 18, 2008 168152 Pundonia Pinto abdomen with Multiple Exploratory Laparotomy General Dr. Abner Dela Cruz Sanitarium and Dyan Marie Lumahang, R.N
Perforation, Laceration of Hospital
Small Intestine Omentum
Mindanao
2 July 18, 2009 173014 Ment Avila Acute Appendicitis Appendectomy Spinal Dr. Abner Dela Cruz Sanitarium and Dyan Marie Lumahang, R.N.
Hospital
Mindanao
Owen Kelly Dela Fracture Open Type I Tibia Minimally Invasive Open
3 October 15, 2009 176839 Spinal Dr. Selwyn Embay Sanitarium and Cristine Faith Damas, R.N.
Calzada – Fibula Distal Third Left Reduction Internal Fixaton
Hospital
Fracture Open Type II
Tibia – Fibula (Commuted) Mindanao
Open Reduction Internal
4 November 24, 2009 177143 Maganara Palao Distal Third Left with Spinal Dr. Selwyn Embay Sanitarium and Dyan Marie Lumahang, R.N.
Fixation
Foreign Body Secondary to Hospital
Gunshot Wound
Intracerebral Hematoma Mindanao
Evacuation and
5 December 05, 2009 177475 Subair Mustapha Right Anterior Parietal General Dr. Valerio Roviro Sanitarium and Juliver Job Garcia, R.N.
Intracerebral Hematoma
Area Hospital

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JIEZLLIZA N. ENCABO
Signature Over Printed Name
Student
Date Signed: _____________
SHEILMA DREAMY G. MANATA, MN, RN PRIMITIVO G. SANTIAS, MN, RN NOEMI T. MORENTE, MAN, RN G’TER G. GAID, MAN, RN
Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name
Clinical Instructor Clinical Coordinator Chief Nurse (MSH) Dean
Date Signed: ______________ Date Signed: ______________ Date Signed: ______________ Date Signed: ______________
a.) PRC No.: 0173264 a.) PRC No.: 0284464 a.) PRC: 0161458 a.) PRC No.: 0302269
Valid Until: May 28, 2011 Valid Until: November 12, 2011 Valid Until: October 1, 2011 Valid Until: September 13, 2012
b.) PNA No.: 024365 b.) PNA No.: 15666 b.) PNA: 15898 b.) PNA No: 16832
Valid Until: October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime
c.) ANSAP No: 05068 c.) ADPCN No.: 0768
Valid Until: January 01, 2011 Valid Until: 2011
 Mindanao Sanitarium & Hospital College
Brgy. San Miguel, Iligan City 9200

Name of the Student: Jiezlliza N. Encabo

Name & Address of School: Mindanao Sanitarium and Hospital College, Barangay San Miguel, Iligan City School code: 1362
Accreditation Level: Level 1 Year Granted: February 28, 2008
Date School Program was Recognized: Oct. 17, 2002 Number: 0043 Year: 2002
First Course (If any): N/A_________________________________________ School Graduated From: N/A____________________ Year: N/A ____
Year of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated from the BSN Program: 2010

II. MINOR OPERATIONS

Signature of
Operation Type of Name of O.R. Scrub
NO. Date of Operation Case No. Name of Patient Diagnosis Name of Surgeon Name of Hospital O.R. Scrub
Performed Anesthesia Nurse
Nurse
Removal of Foreign
Punctured Wound with Foreign Bodies , Suturing Lanao Del Norte
1 July 19, 2008 003049 Darwin Maglasang Local Dr. Ricardo Muňasque Josefina F. Apat, RN
Bodies Posterior Neck and Debridement Provincial Hospital
with Drain
Operation of
August 15, 2008 Lanao Del Norte
2 003085 Floredith Ong Multiple Foreign Bodies at Left Eye Foreign Bodies at Local Dr. Demetrio Opamen Jr. Josefina F. Apat, RN
Provincial Hospital
Left Eye

Amputated Distal Phalanx First Lanao Del Norte

3 February 11, 2009 002009 Victoria Socias Suturing Local Dr. Grace Yañez Teresita F. Birondo, RN
Digit Left Hand Provincial Hospital

Rural Health Unit

4 March 22, 2009 012 Clint Nabangue Phimosis Circumcision Local Dr. Edsel Regin Cabaluna Hinaplanon, Iligan Audie Marc B. Israel, RN
City
Abrasion at Upper Lip Right and
Lanao Del Norte
5 April 07, 2009 003359 Rowel Tañedo Left Arm with Multiple Bruises at Debridement Local Dr. Anisa Pacasum Teresita F. Birondo, RN
Provincial Hospital
Right Leg and Left Foot

Prepared by: Supervised by: Noted by: Concurred by: Approved by:

JIEZLLIZA N. ENCABO SHEILMA DREAMY G. MANATA, MN, RN PRIMITIVO G. SANTIAS, MN, RN NOEMI T. MORENTE, MAN, RN TRANSFIGURATION C. LEE, MN, RN G’TER G. GAID, MAN, RN
Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name
Student Clinical Instructor Clinical Coordinator Chief Nurse (MSH) Chief Nurse (LNPH) Dean
Date Signed: ________ Date Signed: ______________ Date Signed: ______________ Date Signed: ______________ Date Signed: ______________ Date Signed: ____________
a.) PRC No.: 0173264 a.) PRC No.: 0284464 a.) PRC: 0161458 a.) PRC No.: 059574 a.) PRC No.: 0302269
Valid Until: May 28, 2011 Valid Until: November 12, 2011 Valid Until: October 1, 2011 Valid Until: August 6, 2011 Valid Until: September 13, 2012
b.) PNA No.: 024365 b.) PNA: 15898 b.) PNA No: 16832 b.) PNA No.: 13935 b.) PNA No.: 16832
Valid Until October 31, 2010 Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime
c.) ANSAP No: 05068 c.) ANSAP No: 0513 c.) ADPCN No.: 0768
Valid Until: January 01, 2011 Valid Until: Lifetime Valid Until: 2011
 Mindanao Sanitarium & Hospital College
Brgy. San Miguel, Iligan City 9200

Name of the Student: Jiezlliza N. Encabo

Name & Address of School: Mindanao Sanitarium and Hospital College, Barangay San Miguel, Iligan City School code: 1362_________________________________________
Accreditation Level: Level 1 Year Granted: February 28, 2008
Date School Program was Recognized: October 17, 2002 Number: 0043 Year: 2002
First Course (If any): N/A_________________________________________ School Graduated From: N/A____________________ Year: N/A ____
Year of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated from the BSN Program: 2010

III. ACTUAL DELIVERIES

Supervised by:

Case Time of Gender of

NO. Diagnosis Name of Patient Age Date of Delivery Name of Hospital Type of Delivery
No. Delivery Baby
Faculty with Master’s Degree/Clinical Instructor Nurse/Midwife on Duty

Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM

Pregnancy, Uterine Delivered
1 1627
Cephalic Term Live Birth
Rural Health Unit
Sharon Dela Cruz 38 October 29, 2008 10:20 am Male Spontaneous PRC No. 0173264 PNA No.024365 PRC No.0054561
Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19,2012
Date Signed: Date Signed:_____

Pregnancy, Uterine Delivered Normal DARILYN G. LITERATUS, MN, RN

Lanao del Norte
2 001485 Cephalic Term Live Birth Winalyn Galabay 19 June 29, 2009 9:43 pm Male Spontaneous PRC No. 0301632 PNA No. 016829
Provincial Hospital
Vaginal Delivery Valid Until: November 25, 2010 Valid Until: Lifetime
Date Signed:

Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM

Pregnancy, Uterine Delivered Rural Health Unit
3 05709 Rocelle Ajero 20 July 05, 2009 3:00 am Female Spontaneous PRC No. 0173264 PNA No. 024365 PRC No.0054561
Cephalic Term Live Birth Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM

Pregnancy, Uterine Delivered Rural Health Unit
4 00809 Celia Paug 39 July 25, 2009 1:00 am Female Spontaneous PRC No. 0173264 PNA No. 024365 PRC No.0054561
Cephalic Term Live Birth Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM

Pregnancy, Uterine Delivered Rural Health Unit
5 05709 Jane Dalumangcad 35 July 30, 2009 2:20 pm Male Spontaneous PRC No. 0173264 PNA No. 024365 PRC No.0054561
Cephalic Term Live Birth Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Prepared by: Noted by: Concurred by: Approved by:

JIEZLLIZA N. ENCABO PRIMITIVO G. SANTIAS, MN, RN TRANSFIGURACION C. LEE, MN, RN G’TER G. GAID, MAN, RN
Signature Over Printed Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name
Student Clinical Coordinator Chief Nurse (LNPH) Dean
Date Signed: _____________ Date Signed: ______________ Date Signed:______________ Date Signed:__________
a.) PRC No.: 0284464 a.) PRC No.: 059574 a.) PRC No. 0302269
Valid Until: November 12, 2011 Valid Until: August 6 2011 Valid Until: September 13 2012
b.) PNA No.: 15666 b.) PNA No: 13935 b.) PNA No: 16832
Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime
c.) ADSAP No.: 21 c.) ADPCN No.: 0768
Valid Until: Lifetime Valid Until: 2011
 Mindanao Sanitarium & Hospital College
Brgy. San Miguel, Iligan City 9200

Name of the Student: Jiezlliza N. Encabo

Name & Address of School: Mindanao Sanitarium and Hospital College, Barangay San Miguel, Iligan City School code: 1362_________________________________________
Accreditation Level: Level 1 Year Granted: February 28, 2008
Date School Program was Recognized: October 17, 2002 Number: 0043 Year: 2002
First Course (If any): N/A_________________________________________ School Graduated From: N/A____________________ Year: N/A ____
Year of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated from the BSN Program: 2010

IV. DELIVERIES ASSISTED

Supervised by:
Case Time of Gender of
NO. Diagnosis Name of Patient Age Date of Delivery Name of Hospital Type of Delivery
No. Delivery Baby
Faculty with Master’s Degree/Clinical Instructor Nurse/Midwife on Duty

Primigravida Pregnancy
Normal SHEILMA DREAMY G. MANATA, MN, RN
Uterine 33 Weeks Livebirth Mindanao Sanitarium
1 163016 Hezell Rosa 19 September 04, 2008 10:38 pm Male Spontaneous PRC No. 0173264 PNA No.024365
Asphyxated Premature Baby and Hospital
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010
Boy
Date Signed:

Pregnancy, Uterine Delivered Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM
Rural Health Unit
2 09709 Cephalic Term Live Birth Ester Sapip 29 June 27, 2009 3:00 am Female Spontaneous PRC No. 0173264 PNA No.024365 PRC No.0054561
Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Pregnancy, Uterine Delivered Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM
Rural Health Unit
3 81809 Cephalic Term Live Birth Fretzie Tugahan 22 June 29, 2009 11:00 pm Female Spontaneous PRC No. 0173264 PNA No.024365 PRC No.0054561
Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Normal SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, RM

Pregnancy, Uterine Delivered Rural Health Unit
4 20609 Naneth Magabuyo 25 July 13, 2009 4:20 pm Male Spontaneous PRC No. 0173264 PNA No.024365 PRC No.0054561
Cephalic Term Live Birth Tibanga, Iligan City
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Normal SHEILMA DREAMY G. MANATA, MN, RN

Pregnancy, Uterine Delivered Mindanao Sanitarium
5 196723 Sohria Ampuan 36 August 24, 2009 8:25 pm Male Spontaneous PRC No. 0173264 PNA No.024365
Cephalic Term Live Birth and Hospital
Vaginal Delivery Valid Until: May 28, 2011 Valid Until: October 31, 2010
Date Signed:

Prepared by: Noted by: Concurred by: Approved by:

JIEZLLIZA N. ENCABO PRIMITIVO G. SANTIAS, MN, RN NOEMI T. MORENTE, MAN, RN G’TER G. GAID, MAN, RN
Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name Signature Over Printed Name
Student Clinical Coordinator Chief Nurse (MSH) Dean
Date Signed: _____________ Date Signed:______________ Date Signed:______________ Date Signed:______________
a.) PRC No.: 0284464 a.) PRC: 0161458 a.) PRC No.: 0302269
Valid Until: November 12, 2011 Valid Until: October 1, 2011 Valid Until: September 13, 2012
b.) PNA No.: 15666 b.) PNA: 15898 b.) PNA No: 16832
Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime
c.) ANSAP No: 05068 c.) ADPCN No.: 0768
Valid Until: January 01, 2011 Valid Until: 2011
 Mindanao Sanitarium & Hospital College
Brgy. San Miguel, Iligan City 9200
Name of the Student: Jiezlliza N. Encabo
Name & Address of School: Mindanao Sanitarium and Hospital College, Barangay San Miguel, Iligan City School code: 1362_________________________________________
Accreditation Level: Level 1 Year Granted: February 28, 2008
Date School Program was Recognized: October 17, 2002 Number: 0043 Year: 2002
First Course (If any): N/A_________________________________________ School Graduated From: N/A____________________ Year: N/A ____
Year of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated from the BSN Program: 2010

V. CORD DRESSING

Supervised by:
Case Gender of Name of Hospital/Lying
NO. Date Performed Name of Baby Name of Mother Age
No. Baby In Clinic/ Home Delivery
Faculty with Master’s Degree/Clinical Instructor Nurse/Midwife on Duty

DARILYN G. LITERATUS, MN, RN

Lanao Del Norte Provincial
1 002350 February 26, 2009 Regino Baby Girl Female Jennifer Regino 25 PRC No. 0301632 PNA No. 016829
Hospital
Valid Until: November 25, 2010 Valid Until: Lifetime
Date Signed:

DARILYN G. LITERATUS, MN, RN

Lanao del Norte Provincial
2 004215 April 08, 2009 Torrecampo Baby Boy Male Kristine Torrecampo 24 PRC No. 0301632 PNA No. 016829
Hospital
Valid Until: November 25, 2010 Valid Until: Lifetime
Date Signed::

SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, Rm

Rural Health Unit Tibanga,
3 19309 August 03, 2009 Angelou Vence Osados Male Anerealiza Osados 34 PRC No. 0173264 PNA No.024365 PRC No.0054561
Iligan City
Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed Date Signed:_____

Rural Health Unit Tibanga, SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, Rm
4 78409 August 14, 2009 Romeo Adriane Lumasag Male Arriane Lumasag 19 Iligan City PRC No. 0173264 PNA No.024365 PRC No.0054561
Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed: Date Signed:_____

Rural Health Unit Tibanga, SHEILMA DREAMY G. MANATA, MN, RN Helen R. Ungab, Rm
5 87609 September 05, 2009 Dimple Gomer Female MaryJane Gomer 25 Iligan City PRC No. 0173264 PNA No.024365 PRC No.0054561
Valid Until: May 28, 2011 Valid Until: October 31, 2010 Valid Until:October 19, 2012
Date Signed Date Signed:_____

Prepared by: Noted by: Concurred by: Approved by:

JIEZLLIZA N. ENCABO PRIMITIVO G. SANTIAS, MN, RN TRANSFIGURATION C. LEE, MN, RN G’TER G. GAID, MAN, RN
Signature Over Printed Signature Over Printed Name Signature Over Printed Name of Signature Over Printed
Name of Student of Clinical Coordinator Chief Nurse (LNPH) Name of Dean
Date Signed: _____________ Date Signed: ______________ Date Signed: ______________ Date Signed: ______________
a.) PRC No.: 0284464 a.) PRC No.: 059574 a.) PRC No.: 0302269
Valid Until: November 12, 2011 Valid Until: August 06, 2011 Valid Until: September 13 2012
b.) PNA No.: 15666 b.) PNA No: 13935 b.) PNA No.: 16832
Valid Until: Lifetime Valid Until: Lifetime Valid Until: Lifetime
c.) ANSAP No.: 21 c.) ADPCN No.: 0768
Valid Until: Lifetime Valid Until: 2011