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IMMEDIATE NEWBORN CARE in JOSE R. REYES MEMORIAL MEDICAL CENTER, CITY OF MANILA
Hospital, Municipality/City/Province
Prepared by:
Printed Name with Signature of Student: CAYABYAB, NOVABELLE GATAN
Date Performed Patient’s INITIALS (only) Immediate Newborn Cord Care D.R. Nurse on Duty SUPERVISED BY
and Case Number PERFORMED (Name and Signature) Clinical Instructor
Time Started (Not applicable for Birthing/Lying-In (Indicate where performed e.g. (If Midwife on Duty, (Name and Signature)
Clinics/Homes) D.R., Nursery, NICU, or Home) Signature not Required)
JULIE CARDONA DANOFRATA, RN, MAN MA. BELINDA G. BUENAFE, RN, MAN, PhD
Signature over printed name of Clinical Coordinator Signature over printed name of Dean
Date signed: Date signed:
Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Major in Educational Management
PRC Lic. No.: 0193682 PRC Lic. No. : 0067727
Valid Until: June 15, 2020 Valid Until: February 26, 2021
PNA No. : 18023 PNA No. : 16797
Valid Until: Lifetime Valid Until: Lifetime
ADPCN No. : 11 - 568
Valid Until: May 31, 2020