College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Date: Concepcion Disrict Hospital Shift: 7-7

December 7, 2010

Name of Student: Merro G. Kelly Name of Patient:

Remedios First Name

Romanio Middle Name

Aliling Family Name

Case Number: 10-10-1702 Time Started: 10:25 AM Age: 48 Sex: F 1st Assistant: Dr. Edwardo Tuazon 2nd Assistant: Dr. Eliseo Bungay Jr. Anesthesiologist: Dr. Elsa Rivera Type of Anesthesia: Spinal /IV-GA Pre-Op Diagnosis: Cholecystolithiasis, Breast Mass (Huge) Left Surgical Procedure Performed: Cholecystectomy, Lumpectomy, Left Breast

Student Nurse: Instrument Nurse: Merro G. Kelly Circulating Nurse: Lloyd Franco S. Camiguing

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature:

College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Date: Concepcion Disrict Hospital Shift: 7-7

December 15, 2010

Name of Student: Merro G. Kelly Name of Patient:

Ma. Lenah First Name

Rusu Middle Name

Madang Family Name

Case Number: 10-12-977 Time Started: 6:45 PM Age: 25 Sex: F 1st Assistant: Dr. Lolita Ong 2nd Assistant: Anesthesiologist: Dr. Rommel Basilio Type of Anesthesia: Spinal Pre-Op Diagnosis: Preganacy Uterine, 41 weeks Age of Gestation, not in labor, post datism, G1P0 Surgical Procedure Performed: Low Transverse Cesarean Section

Student Nurse: Instrument Nurse: Merro G. Kelly Circulating Nurse: Lloyd Franco S. Camiguing

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature:

College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Date: Concepcion Disrict Hospital Shift: 7-7

August 25, 2011

Name of Student: Merro G. Kelly Name of Patient:

Annette First Name

Apostol Middle Name

Loresco Family Name

Case Number: 11-08-2226 Time Started: 4:30 PM Age: 42 Sex: F 1st Assistant: Dr. Mary Karen Atanacio 2nd Assistant: Dr. Annaliza Aguilar Anesthesiologist: Dr. Rommel Basilio Type of Anesthesia: Spinal Pre-Op Diagnosis: Dysfunctional Uterine Bleeding, G1P1 (1001) Surgical Procedure Performed: Total Abdominal Hysterectomy Bilateral Salpingo-Oophorectomy

Student Nurse: Instrument Nurse: Merro G. Kelly Circulating Nurse: Lloyd Franco S. Camiguing

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature:

College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Date: Concepcion Disrict Hospital Shift: 7-7

December 3, 2010

Name of Student: Lloyd Franco S. Camiguing Name of Patient:

Julie First Name

Pineda Middle Name

Calma Family Name

Case Number: 10-08-452 Time Started: 6:15 PM Age: 34 Sex: F 1st Assistant: Dr. Mary Karen Atanacio 2nd Assistant: Anesthesiologist: Dr. Rommel Basilio Type of Anesthesia: Spinal Pre-Op Diagnosis: G2P1 (1001) Pregnancy Uterine 37 weeks Age of Gestation, Previous Cesarean Section, Multiple Pregnancy Surgical Procedure Performed: Low Transverse Cesarean Section, Bilateral Tubal Ligation

Student Nurse: Instrument Nurse: Lloyd Franco S. Camiguing Circulating Nurse: Merro G. Kelly

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature:

College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Date: Concepcion Disrict Hospital Shift: 7-7

August 4, 2011

Name of Student: Lloyd Franco S. Camiguing Name of Patient:

Salustranio First Name

Baquing Middle Name

David Family Name

Case Number: 11-08-226 Time Started: 2:15 PM Age: 50 Sex: M 1st Assistant: Dr. Benjamin Bangco III 2nd Assistant: Dr. Gener Apostol Anesthesiologist: Dr. Rommel Basilio Type of Anesthesia: Epidural Pre-Op Diagnosis: Benign Prostatic Hypertrophy Surgical Procedure Performed: Suprapubic Prostatectomy

Student Nurse: Instrument Nurse: Lloyd Franco S. Camiguing Circulating Nurse: Merro G. Kelly

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature:

College of the Holy Spirit of Tarlac College of Nursing

SURGICAL SLIP Health Care Agency: Concepcion Disrict Hospital Date:

August 12, 2011

Shift: 7-7

Name of Student: Lloyd Franco S. Camiguing Name of Patient:

Arlene First Name

Cono Middle Name

Erese Family Name

Case Number: 11-08-736 Time Started: 11:30 AM Age: 49 Sex: F 1st Assistant: Dr. Benjamin Bengco III 2nd Assistant: Dr. Gener Apostol Anesthesiologist: Dr. Rommel Basilio Type of Anesthesia: Epidural Pre-Op Diagnosis: Pyelonephrosis secondary to Pyelonephritis Surgical Procedure Performed: Nephrostomy, Left

Student Nurse: Instrument Nurse: Lloyd Franco S. Camiguing Circulating Nurse: Merro G. Kelly

OR on Duty:

Perpetua First Name License Number: Clinical Instructor: License Number: 133320 Juliet Aguilar Hipolito 02-61361

Lim Middle Name Signature:

Liwanag Family Name

Signature: