Final Arlene Cris Damot

LA CONSOLACION COLLEGE MANILA #8 Mendiola St., Mendiola Manila (02) 736-02035 / (02) 313-0513 / http://www.lccm.edu.
ph Government Recognition Level IV, No. 17 on January 23, 2006

Prepared By: ARLENE CRIS A. DAMOT
No .
1.
ODC Form 1 O.R. MAJOR FORM
Signature of Student: ______________________

CASE NUMBER PROCEDURE PERFORMED
Exploratory Laparotomy (Evacuation of Retroperitoneal Hematoma) Under General Anesthesia Radical Mastectomy AS Under General Endotracheal Anesthesia Parotidectomy Right Under General Endotracheal Anesthesia Modified Radical Mastectomy Left Side Under General Endotracheal Anesthesia Open Cholecystectomy Under General Endotracheal Anesthesia
DATE PERFORMED
TIME STARTED
NAME OF PATIENT
Abigail Tailod
OR NURSE ON DUTY
SUPERVISED BY
HOSPITAL
Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila
07/04/11
11:33 AM
2329680
Yolanda C. Canlas, RN
_______________________ Mylin M. Bathan, RN, MAN _______________________ Mylin M. Bathan, RN, MAN _______________________ Mylin M. Bathan, RN, MAN _______________________ Mylin M. Bathan, RN, MAN _______________________ Mylin M. Bathan, RN, MAN
2.
07/05/11
7:28 AM
Allan Rejuso
1634102
Marjorie B. Vergara, RN
3.
07/05/11
12:40 PM
Gloria Caudilla
1614512
4.
07/11/11
8:05 AM
Gonita Verdeflor
1634319
Medel A.Quilet, RN
5.
07/13/11
6:55 AM
Cherrie Ann Ong
1634688
Concurred By:
Noted by:
Approved by:
_______________________________________ ASUNCION C. BALISADO Chief Nurse PRC No: 0116547 Valid Until: Aug 2012 PNA No: 14782 Valid Until: Lifetime Date signed: _________ Time: _________ Nursing Degrees: RN, MAN F-SCNU-005 (Rev1-January 01, 2010)
_______________________________________ CHRISTOPHER A. DE LUNA Clinical Coordinator PRC No: 0372099 Valid Until: Jul 2014 PNA No: 19741 Valid Until: Lifetime Date signed: _________ Time: __________ Nursing Degrees: RN, RM, MSN, MAN
_______________________________________ ALEJANDRO F. SORITA Dean, School of Nursing and Allied Sciences PRC No: 0305011 Valid Until: Dec 2012 PNA No: 2012-036301 Valid Until: 2012 ADPCN No: 11-248 Valid Until: 2012 Date signed: _________ Time: __________ Nursing Degrees: RN, MAN
LA CONSOLACION COLLEGE MANILA #8 Mendiola St., Mendiola Manila (02) 736-02035 / (02) 313-0513 / http://www.lccm.edu.ph Government Recognition Level IV, No. 17 on January 23, 2006
No . DATE PERFORMED TIME STARTED NAME OF PATIENT CASE NUMBER PROCEDURE PERFORMED
ODC Form 2 O.R. MINOR FORM
Signature of Student: _____________________

OR NURSE ON DUTY SUPERVISED BY HOSPITAL
1.
07/04/11
8:07 AM
Alfredo Balaca
2327500
Hemorrhoidectomy Under Spinal Anesthesia
_______________________ Mylin M. Bathan, RN, MAN
Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila Ospital ng Maynila Medical Center Ermita, Manila
2.
07/04/11
10:30 AM
Marlon Pinca
1630802
Fistulotomy Under Spinal Anesthesia
Julieta A. Quilinderino, RN
3.
07/06/11
10:10 AM
Bernardino Waje
2327165
Debridement Cellulitits L Foot Under Local Anesthesia Extra Capsular Cataract Extraction Under Local Anesthesia Hernioplasty L Under Spinal Anesthesia
4.
07/13/11
7:45 AM
Gina De Tablan
2321919
Julieta A. Quilinderino, RN
5.
07/13/11
10:55 AM
Manuel Conche
1630971
Timothy Francis Lerma, RN
Concurred By:
Noted by:
Approved by:
_______________________________________ ASUNCION C. BALISADO Chief Nurse PRC No: 0116547 Valid Until: Aug 2012 PNA No: 14782 Valid Until: Lifetime Date signed: _________ Time: _________ Nursing Degrees: RN, MAN
No .
1.
ODC Form 3 ACTUAL DELIVERY

Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
DATE PERFORMED
TIME STARTED
NAME OF PATIENT
Liezel Luna
DR NURSE / MIDWIFE ON DUTY
SUPERVISED BY
HOSPITAL
Dr. Montano G. Ramos General Hospital Bago Bantay, Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay, Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay, Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay, Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay, Quezon City
01/31/11
7:05 PM
20680
Myra A. Mantula , RN
_________________________ Concemarcia V. Bacon, RN, MAN _________________________ Concemarcia V. Bacon, RN, MAN _________________________ Concemarcia V. Bacon, RN, MAN _________________________ Concemarcia V. Bacon, RN, MAN _________________________ Concemarcia V. Bacon, RN, MAN
2.
01/31/11
1:01 PM
Khezel Dumlao
20681
Aileen T. Vesperas, RN
3.
07/18/11
2:30 PM
Maricel Isanan
20578
Dearly Gumapos, RN
4.
07/19/11
3:36 PM
Lorelyn Gaan
20576
Dearly Gumapos, RN
5.
10/19/11
3:36 PM
Cristy Gabriel
21717
May S. Jandumon, RM
Concurred By:
Noted by:
Approved by:
_______________________________________ Tonnette E. dela Rea Chief Nurse PRC No: 0311700 Valid Until: Nov 2014 PNA No: 17983 Valid Until: Lifetime Date signed: _________ Time: _________ Nursing Degrees: RN, MAN
No .
1.
ODC Form 4 ASSIST DELIVERY

Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery
DATE PERFORMED
TIME STARTED
NAME OF PATIENT
Rowena Cadag
DR NURSE / MIDWIFE ON DUTY
SUPERVISED BY
HOSPITAL
Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City
01/28/11
5:50 PM
20668
Aileen T. Vesperas, RN
2.
02/05/11
1:39 PM
Johan Bautista
20694
Imelda D. Espiritu, RM
3.
07/19/11
10:50 PM
Rose Pimentel
20579
Dearly Gumapos, RN
4.
07/27/11
5:18 PM
Mary Rose Rando
20632
Dearly Gumapos, RN
5.
10/20/11
1:12 PM
Gracelle Tordillo
22259
Sheryl Ferran, RM
Concurred By:
Noted by:
Approved by:
No .
1.
ODC Form 5 NEWBORN CARE

CASE NUMBER NEWBORN CORD CARE PERFORMED DR NURSE / MIDWIFE ON DUTY SUPERVISED BY
DATE PERFORMED
TIME STARTED
NAME OF PATIENT
HOSPITAL
Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City Dr. Montano G. Ramos General Hospital Bago Bantay Quezon City
02/11/11
9:41 PM
Baby Girl Fernandez
20678
Nursery
Aileen Vesperas, RN
2.
07/26/11
9:15 PM
Baby Boy Laje
20626
Nursery
Dearly Gumapos, RN
3.
10/19/11
9:41 PM
Baby Girl Arreza
16878
Nursery
May S. Jandumon, RM
4.
10/20/11
3:40 PM
Baby Boy Carpio
22256
Nursery
Myra Mantala, RM
5.
10/20/11
4:15 PM
Baby Girl Gorgonio
22058
Nursery
Myra Mantala, RM
Concurred By:
Noted by:
Approved by:

Final Arlene Cris Damot

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LA CONSOLACION COLLEGE MANILA #8 Mendiola St., Mendiola Manila (02) 736-02035 / (02) 313-0513 / http://www.lccm.edu.

ph Government Recognition Level IV, No. 17 on January 23, 2006

ODC Form 1 O.R. MAJOR FORM

Signature of Student: ______________________

Cherrie Ann Ong

ODC Form 2 O.R. MINOR FORM

Signature of Student: _____________________

Hemorrhoidectomy Under Spinal Anesthesia

_______________________ Mylin M. Bathan, RN, MAN

Fistulotomy Under Spinal Anesthesia

_______________________ Mylin M. Bathan, RN, MAN

_______________________ Mylin M. Bathan, RN, MAN

_______________________ Mylin M. Bathan, RN, MAN

Timothy Francis Lerma, RN

_______________________ Mylin M. Bathan, RN, MAN

ODC Form 3 ACTUAL DELIVERY

Signature of Student: ______________________

DR NURSE / MIDWIFE ON DUTY

ODC Form 4 ASSIST DELIVERY

Signature of Student: ______________________

DR NURSE / MIDWIFE ON DUTY

Mary Rose Rando

ODC Form 5 NEWBORN CARE

Signature of Student: ______________________

Baby Girl Fernandez

Baby Boy Laje

Baby Girl Arreza

Baby Boy Carpio

Baby Girl Gorgonio

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