Name of Student: VIDAL, CELESTE BALBIN Name & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay City Accreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011 Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981 First Course (if any): Not Applicable School Graduated From: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2006 Year Graduated (BSN Program): 2010 I. Major Operations No Date of Operatio n Case No. Name of Patient Diagnosis Operation Performed Type of Anesthe sia Name of Surgeon Name of Hospital Name and Signature of O.R. Scrub Nurse Supervised by Qualified Clinical Instructor 1 March 10, 2010 1234 C.B.V. Chronic Calculi Cholecysti Cholecystec tomy General Dr. Nicomedes Cruz Manila Doctors Hospital ___________________ ___ Mark Vincent Macapagal, RN _________________________________ ___ Celeste B. Vidal, RN, MD, MAN PRC No.: 0296107 PNA 2 3 4 5 Noted by: Evelyn J. Torio Clinical Coordinator Manila Doctors College Date Signed: __________ Degree: RN, MAN a. PRC No.: 0088770 Valid Until: October 23, 2010 b. PNA No.: 008328 Concurred by: Celeste B. Vidal Chief Nurse Manila Doctors Hospital Date Signed: ___________ Degree: RN, MD, MAN a. PRC No.: 0296107 Valid Until: November 16, 2012 b. PNA No.: 049809 Approved by: Norma M. Dumadag Dean, College of Nursing Manila Doctors College Date Signed: ___________ Degree: RN, MN a. PRC No.: 0018659 Valid Until: December 29, 2011 b. PNA No.: 5350
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Name of Student: VIDAL, CELESTE BALBINName & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay CityAccreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981First Course (if any): Not Applicable School Graduated From: Not ApplicableYear of Admission in the Bachelor of Science in Nursing Program: 2006Year Graduated (BSN Program): 2010
I. Major Operations
NoDate of
OperationCase No.
Name of Patient
DiagnosisOperation Performed
Type of Anesthesia
Name of Surgeon
Name of Hospital
Name and Signature of O.R. Scrub Nurse
Supervised by Qualified Clinical Instructor
1 March 10, 2010
1234 C.B.V.Chronic Calculi
CholecystitisCholecystectomy General
Dr. Nicomedes Cruz
Manila Doctors Hospital
______________________Mark Vincent Macapagal,
RN
____________________________________Celeste B. Vidal, RN, MD, MAN
PRC No.: 0296107 PNA No.: 049809Valid Until: November 16, 2012 Valid Until: October 31, 2010
2
3
4
5
Noted by:
Evelyn J. Torio Clinical Coordinator
Manila Doctors CollegeDate Signed: __________ Degree: RN, MAN a. PRC No.: 0088770Valid Until: October 23, 2010b. PNA No.: 008328Valid Until: October 2010
Concurred by:
Celeste B. VidalChief Nurse
Manila Doctors HospitalDate Signed: ___________Degree: RN, MD, MAN a. PRC No.: 0296107Valid Until: November 16, 2012b. PNA No.: 049809Valid Until: October 31, 2010
Approved by:
Norma M. DumadagDean, College of NursingManila Doctors College
Date Signed: ___________Degree: RN, MN a. PRC No.: 0018659 Valid Until: December 29, 2011b. PNA No.: 5350Valid Until: Lifetimec. ADPCN: 0802Valid Until: October 2009
Name of Student: VIDAL, CELESTE BALBINName & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay CityAccreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981First Course (if any): Not Applicable School Graduated From: Not ApplicableYear of Admission in the Bachelor of Science in Nursing Program: 2006Year Graduated (BSN Program): 2010
____________________________________Celeste B. Vidal, RN, MD, MAN
PRC No.: 0296107 PNA No.: 049809Valid Until: November 16, 2012 Valid Until: October 31, 2010
2
3
4
5
Noted by:
Evelyn J. Torio Clinical Coordinator
Manila Doctors CollegeDate Signed: __________ Degree: RN, MAN a. PRC No.: 0088770Valid Until: October 23, 2010b. PNA No.: 008328Valid Until: October 2010
Concurred by:
Celeste B. VidalChief Nurse
Manila Doctors HospitalDate Signed: ___________Degree: RN, MD, MAN a. PRC No.: 0296107Valid Until: November 16, 2012b. PNA No.: 049809Valid Until: October 31, 2010
Approved by:
Norma M. DumadagDean, College of NursingManila Doctors College
Date Signed: ___________Degree: RN, MN a. PRC No.: 0018659 Valid Until: December 29, 2011b. PNA No.: 5350Valid Until: Lifetimec. ADPCN: 0802Valid Until: October 2009
Name of Student: VIDAL, CELESTE BALBINName & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay CityAccreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981First Course (if any): Not Applicable School Graduated From: Not ApplicableYear of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated (BSN Program): 2010
III. Actual Deliveries
No Case No. DiagnosisName of Mother
Age Date of
DeliveryTime of Delivery
Gender of Baby
Name of Hospital Type of DeliverySupervised by Qualified
Clinical Instructor
1 1234
Pregnancy Uterine Full Term 39 5/7 Weeks.
Age of Gestation, Cephalic in Labor, Gravida 3 Parity 2
C.B.V. 28 March 10,
20101:00 am Boy
Manila Doctors Hospital
Normal Spontaneous
Delivery
____________________________________Celeste B. Vidal, RN, MD, MAN
PRC No.: 0296107 PNA No.: 049809Valid Until: November 16, 2012 Valid Until: October 31, 2010
2
3
4
5
Noted by:
Evelyn J. Torio Clinical Coordinator
Manila Doctors CollegeDate Signed: __________ Degree: RN, MAN a. PRC No.: 0088770Valid Until: October 23, 2010b. PNA No.: 008328Valid Until: October 2010
Concurred by:
Celeste B. VidalChief Nurse
Manila Doctors HospitalDate Signed: ___________Degree: RN, MD, MAN a. PRC No.: 0296107Valid Until: November 16, 2012b. PNA No.: 049809Valid Until: October 31, 2010
Approved by:
Norma M. DumadagDean, College of NursingManila Doctors College
Date Signed: ___________Degree: RN, MN a. PRC No.: 0018659 Valid Until: December 29, 2011b. PNA No.: 5350Valid Until: Lifetimec. ADPCN: 0802Valid Until: October 2009
Name of Student: VIDAL, CELESTE BALBINName & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay CityAccreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981First Course (if any): Not Applicable School Graduated From: Not ApplicableYear of Admission in the Bachelor of Science in Nursing Program: 2006
Year Graduated (BSN Program): 2010
IV. Assisted Deliveries
No Case No. DiagnosisName of Mother
Age Date of
DeliveryTime of Delivery
Gender of Baby
Name of Hospital Type of DeliverySupervised by Qualified
Clinical Instructor
1 1234
Pregnancy Uterine Full Term 39 5/7 Weeks.
Age of Gestation, Cephalic in Labor, Gravida 3 Parity 2
C.B.V. 28 March 10,
20101:00 am Boy
Manila Doctors Hospital
Normal Spontaneous
Delivery
____________________________________Celeste B. Vidal, RN, MD, MAN
PRC No.: 0296107 PNA No.: 049809Valid Until: November 16, 2012 Valid Until: October 31, 2010
2
3
4
5
Noted by:
Evelyn J. Torio Clinical Coordinator
Manila Doctors CollegeDate Signed: __________ Degree: RN, MAN a. PRC No.: 0088770Valid Until: October 23, 2010b. PNA No.: 008328Valid Until: October 2010
Concurred by:
Celeste B. VidalChief Nurse
Manila Doctors HospitalDate Signed: ___________Degree: RN, MD, MAN a. PRC No.: 0296107Valid Until: November 16, 2012b. PNA No.: 049809Valid Until: October 31, 2010
Approved by:
Norma M. DumadagDean, College of NursingManila Doctors College
Date Signed: ___________Degree: RN, MN a. PRC No.: 0018659 Valid Until: December 29, 2011b. PNA No.: 5350Valid Until: Lifetimec. ADPCN: 0802Valid Until: October 2009
Name of Student: VIDAL, CELESTE BALBINName & Address of School: Manila Doctors College, President Diosdado Macapagal Boulevard, Metropolitan Park, Pasay CityAccreditation Level (if any): PAASCU Level II Re-accredited Status Year Granted: January 31, 2009 to November 2011Date School/Program was Recognized: July 6, 1981 Number: 098 Year: 1981First Course (if any): Not Applicable School Graduated From: Not ApplicableYear of Admission in the Bachelor of Science in Nursing Program: 2006Year Graduated (BSN Program): 2010
V. Cord Dressing
o Case No.Date
PerformedName of Baby
Gender of Baby
Name of Mother Age Name of HospitalSupervised by Qualified