OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City

Name of Student: QUIONES RIZALYN GUNDRAN________________________________________________________________________________________________________________________________
Name and Address of School: OUR LADY OF FATIMA UNIVERSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________________________________________
Accreditation Level (if any): PACUCOA LEVEL II__________________________Year Granted: APRIL 10, 2002_________________________________________________________________________________
Date School/Program was Recognized: APRIL 25, 2001____________________Number: 033____________________________
Year: 2001__________________________________________________
First Course (if any): BS ACCOUNTANCY__________________School Graduated From: MANUEL L. QUEZON UNIVERSITY
Year: 1995__________________________________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________________________________________________________________________________________________________________
Year Graduated (BSN Program): MARCH 2010
___________________________________________________
__
No.

I. Major Operations
Type of
Name of Surgeon
Anesthesia

Date of
Operation

Case No.

Name of
Patient

Diagnosis

Operation Performed

1.

June 02,
2009

2-200528813

Rebecca P.
Medina

Nodular Non Toxic

Goiter

Thyroidectomy

General
Anesthesia

Dr. Don Barcelona

Congressman Rogaciano M.
Mercado Memorial Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

2.

June 03,
2009

2-20099430

Salud
Esteban
Gabal

Breast Cancer Left

Modified Radical
Mastectomy Left

Spinal
Anesthesia

Dr. Protacio Bajao

Congressman Rogaciano M.
Mercado Memorial Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

3.

June 03,
2009

2-200918873

Marilou J.
Santos

Pregnancy Uterine
Full Term Gravida 3
Parity 2 Previous
Caesarian Section

Low Transverse Caesarian

Section

Spinal
Anesthesia

Dr. Maria Victoria

Bajao

Congressman Rogaciano M.
Mercado Memorial Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

June 03,
2009

2-20097128

Maileen L.
Ramin

Pregnancy Uterine
Full Term Gravida 2
Parity 1 Previous
Caesarian Section

Low Transverse Caesarian

Section

Spinal
Anesthesia

Dr. Jewel Nuez

4.

Congressman Rogaciano M.
Mercado Memorial Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

June 04,
2009

2-200918879

Teresita T.
Rapay

Endometrial Cancer

Radical Extra Fascial

Hysterectomy with Bilateral
Salphingo Oophorectomy;
Lymph Node Dissection

General
Anesthesia

Congressman Rogaciano M.
Mercado Memorial Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

5.

Dr. Protacio Bajao

Dr. Maria Victoria
Bajao
Dr. Tess Rivera

Name of Hospital

Supervised by Qualified CI

Signature of
Qualified CI

Prepared By:

Noted by:

Concurred by:

Approved by:

RIZALYN G. QUIONES
Signature over printed name of student

MARISOL GARCIA-MANIPOL, RN, MAN

Signature over printed name of Clinical
Coordinator
Date Signed: __________
Degree: BSN, MAN
a.) PRC NO: 0296870
Valid Until: September 2012
b.) PNA NO: 013487
Valid Until: October 31, 2010

CATALINA M. HALILI, RN, MAN

Signature over printed name of
Chief Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 041250
Valid Until: February 2013
b.) PNA NO: 19849
Valid Until: Lifetime

NELIA R. CAPULONG, RN, RM, MAN

Signature over printed name of Dean
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0041904
Valid Until: July 31, 2012
b.) PNA NO: 18698
Valid Until: Lifetime
c.) ADPCN NO: 0627
Valid Until: December 2010

Supervised by:
JACQUELYN JOYCE G. GALLER, RN, MAN
Signature over printed name of Faculty
Date Signed: ______
Degree: BSN, MAN
a.) PRC NO: 0411002
Valid Until: July 2012
b.) PNA NO: 077355
Valid until: October 31, 2010

OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: QUIONES RIZALYN GUNDRAN________________________________________________________________________________________________________________________________
Name and Address of School: OUR LADY OF FATIMA UNIVERSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________________________________________
Accreditation Level (if any): PACUCOA LEVEL II__________________________Year Granted: APRIL 10, 2002_________________________________________________________________________________
Date School/Program was Recognized: APRIL 25, 2001____________________Number: 033____________________________
Year: 2001__________________________________________________
First Course (if any): BS ACCOUNTANCY__________________School Graduated From: MANUEL L. QUEZON UNIVERSITY
Year: 1995__________________________________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________________________________________________________________________________________________________________
Year Graduated (BSN Program): MARCH 2010____________________________________________________________________________________________________________________________________
No.

II. Minor Operations

Operation
Type of
Performed
Anesthesia

Date of
Operation

Case No.

Name of
Patient

Diagnosis

1.

January 08,
2009

144763

John Patrick
Manhilot

Lacerated Wound
Forehead Above Left Eyebrow

Suturing

2.

January 15,
2009

144959

Jonikko Winfield
Roxas

Lacerated Wound Left Hand

3.

January 25,
2009

01217

Margarita Chua

May 12,
2009

4488

December
19, 2009

08-11287

4.

5.

Name of
Surgeon

Name of Hospital

Supervised by Qualified CI

Signature of
Qualified CI

Local
Anesthesia

Dr. Rustico
Catalig

Bulacan Maternity
and Childrens
Hospital

Marcellus C. Belisario, RN, MAN

PRC NO: 0349993
PNA NO: 19636

Suturing

Local
Anesthesia

Dr. Rustico
Catalig

Bulacan Maternity
and Childrens
Hospital

Marcellus C. Belisario, RN, MAN

PRC NO: 0349993
PNA NO: 19636

Dysfunctional Uterine Bleeding

Dilatation and
Curettage

Spinal
Anesthesia

Dr. Isabelita
Roquero

Roquero General
Hospita

Norberta C. Alcarion, RN, RM, MAN

PRC NO: 170101
PNA NO: 7994

Jennifer
dela Cruz

Fistula in Anal

Fistulectomy

Spinal
Anesthesia

Dr. Protacio
Bajao

Congressman
Rogaciano M.
Mercado Memorial
Hospital

Jacquelyn Joyce Galler, RN, MAN

PRC NO: 0411002
PNA NO: 077355

Elizabeth
Cuevas

Carbuncle Occipital Area

Incision and
Drainage

Local
Anesthesia

Dr. Ronald
Ibaez

San Jose District

Hospital

Norelyn Q. Jamis, RN, MAN

PRC NO: 0267415
PNA NO: 001098

Prepared By:

Noted by:

Concurred by:

Concurred by:

Concurred by:

Concurred by:

Approved by:

RIZALYN G. QUIONES
Signature over printed name of student

MARISOL GARCIA-MANIPOL, RN, MAN

Signature over printed name of Clinical
Coordinator
Date Signed: __________
Degree: BSN, MAN
a.) PRC NO: 0296870
Valid Until: September 2012
b.) PNA NO: 013487
Valid Until: October 31, 2010

MINERVA ESPINO, RN
Signature over printed name of
Chief Nurse
Date Signed: ___________
Degree: BSN
a.) PRC NO: 0090530
Valid Until: October 10, 2012
b.) PNA NO: 19638
Valid Until: Lifetime

DARWIN HERNANDEZ, RN
Signature over printed name of
Chief Nurse
Date Signed: ___________
Degree: BSN
a.) PRC NO: 0321456
Valid Until: February 24, 2013
b.) PNA NO: 022467
Valid Until: October 2010

CATALINA M. HALILI, RN, MAN

Signature over printed name of
Chief Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 041250
Valid Until: February 2013
b.) PNA NO: 19849
Valid Until: Lifetime

ROSALINDA L. FLORES, RN, MAN

Signature over printed name of Chief
Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 0082223
Valid Until: November 25, 2011
b.) PNA NO: 001097
Valid Until: October 31, 2010

NELIA R. CAPULONG, RN,RM,MAN

Signature over printed name of Dean
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0041904
Valid Until: July 31, 2012
b.) PNA NO: 18698
Valid Until: Lifetime
c.) ADPCN NO: 0627
Valid Until: December 2010

Supervised by:
MARCELLUS C. BELISARIO RN, MAN
Signature over printed name of faculty
Date Signed:_____________
Degree: BSN, MAN
a.) PRC no: 0349993
Valid Until: September 12, 2012
b.) PNA no: 19636
Valid Until: Lifetime

OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: QUIONES RIZALYN GUNDRAN________________________________________________________________________________________________________________________________
Name and Address of School: OUR LADY OF FATIMA UNIVERSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________________________________________
Accreditation Level (if any): PACUCOA LEVEL II__________________________Year Granted: APRIL 10, 2002_________________________________________________________________________________
Date School/Program was Recognized: APRIL 25, 2001____________________Number: 033____________________________
Year: 2001__________________________________________________
First Course (if any): BS ACCOUNTANCY__________________School Graduated From: MANUEL L. QUEZON UNIVERSITY
Year: 1995__________________________________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________________________________________________________________________________________________________________
Year Graduated (BSN Program): MARCH 2010____________________________________________________________________________________________________________________________________
III. Actual Deliveries
Date of
Time of
Gender of
Delivery
Delivery
Baby

No.

Case
No.

Diagnosis

Name of
Mother

Age

Name of Hospital

Type of Delivery

Supervised by: Qualified C.I.

1.

167601

Pregnancy Uterine 39 weeks Age

of gestation Gravida1 Para 0
Cephalic in Labor

Kristine
Alonzo

23

September
02, 2008

2:02 pm

Female

Novaliches District
Hospital

Normal
Spontaneous
Delivery

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

2.

167042

Pregnancy Uterine 38 weeks Age

of gestation Gravida7 Para6
Cephalic in Labor

Marie
Magsaysay

35

September
03, 2008

5:20 pm

Male

Novaliches District
Hospital

Normal
Spontaneous
Delivery

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

3.

16214

Pregnancy Uterine 39 weeks Age

of gestation Gravida2 Para 1
Cephalic in Labor

Jonalyn
Pantoja

21

September
10, 2008

8:20 pm

Male

Novaliches District
Hospital

Normal
Spontaneous
Delivery

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

4.

375895

Pregnancy Uterine 36 weeks Age

of gestation Gravida2 Para 1
Cephalic in Labor

Cherry May
Aquino

21

March 08,
2010

8:42 am

Female

General Gregorio H.
Del Pilar District
Hospital

Normal
Spontaneous
Delivery

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

5.

375960

Pregnancy Uterine 39 weeks Age

of gestation Gravida3 Para 2
Cephalic in Labor

Jean
Hernandez

26

March 09,
2010

8:30 am

Female

General Gregorio H.
Del Pilar District
Hospital

Normal
Spontaneous
Delivery

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

Signature of
Qualified C.I.

Prepared By:

Noted by:

Concurred by:

Concurred by:

Approved by:

RIZALYN G. QUIONES
Signature over printed name of student

MARISOL GARCIA-MANIPOL, RN, MAN

Signature over printed name of Clinical
Coordinator
Date Signed: __________
Degree: BSN, MAN
a.) PRC NO: 0296870
Valid Until: September 2012
b.) PNA NO: 013487
Valid Until: October 31, 2010

JOSEPHINE B. LEONARDO, RN, Ph. D.

Signature over printed name of Chief Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 0081174
Valid Until: April 3, 2011
b.) PNA NO: 15614
Valid Until: Lifetime

ARLENE GALANG-GENEROSA, RN, MAN

Signature over printed name of Chief Nurse
Date Signed: _______
Degree: BSN, MAN
a.) PRC NO: 152240
Valid Until: October 19, 2011
b.) PNA NO: 18248
Valid Until: Lifetime

NELIA R. CAPULONG, RN, RM, MAN

Signature over printed name of Dean
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0041904
Valid Until: July 31, 2012
b.) PNA NO: 18698
Valid Until: Lifetime
c.) ADPCN NO: 0627
Valid Until: December 2010

Supervised by:
ROSANIE MORO, RN, Ph. D.
Signature over printed name of Faculty
Date Signed: ____________
Degree: BSN, Ph. D.
a.) PRC NO: 664911
Valid Until: November 8, 2012
b.) PNA NO: 002436
Valid Until: October 2010

OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: QUIONES RIZALYN GUNDRAN________________________________________________________________________________________________________________________________
Name and Address of School: OUR LADY OF FATIMA UNIVERSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________________________________________
Accreditation Level (if any): PACUCOA LEVEL II__________________________Year Granted: APRIL 10, 2002_________________________________________________________________________________
Date School/Program was Recognized: APRIL 25, 2001____________________Number: 033____________________________
Year: 2001__________________________________________________
First Course (if any): BS ACCOUNTANCY__________________School Graduated From: MANUEL L. QUEZON UNIVERSITY
Year: 1995__________________________________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________________________________________________________________________________________________________________
Year Graduated (BSN Program): MARCH 2010____________________________________________________________________________________________________________________________________
No.

1.

2.

3.

4.

5.

IV. Deliveries Assisted

Date of
Time of
Delivery
Delivery

Case No.

Diagnosis

Name of Mother

Age

Gender
of Baby

Name of Hospital

Type of
Delivery

Supervised by: Qualified C.I.

166464

Pregnancy Uterine Full Term

Gravida 3 Para 2
Cephalic in Labor

Myra Velez

32

August 07, 2008

3:40 pm

Male

Novaliches District
Hospital

Normal
Spontaneous
Delivery

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

157997

Pregnancy Uterine Full Term

Gravida 1 Para 0
Cephalic in Labor

Wendelyn
Perez

19

September 10,
2008

4:15 pm

Female

Novaliches District
Hospital

Normal
Spontaneous
Delivery

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

375536

Pregnancy Uterine 38 weeks Age

of gestation Gravida2 Para 1
Cephalic in Labor

Marlyn Abelin

24

February 25,
2010

8:07 am

Female

General Gregorio H.
Del Pilar District
Hospital

Normal
Spontaneous
Delivery

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

375744

Pregnancy Uterine 38 weeks Age

of gestation Gravida1 Para 0
Cephalic in Labor

Joanna Carronigo

20

March 04,
2010

1:46 pm

Female

General Gregorio H.
Del Pilar District
Hospital

Normal
Spontaneous
Delivery

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

376105

Pregnancy Uterine 39 weeks Age

of gestation Gravida3 Para 2
Cephalic in Labor

Rochelle
Francisco

27

March 15,
2010

8:30 am

Male

General Gregorio H.
Del Pilar District
Hospital

Normal
Spontaneous
Delivery

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

Signature of
Qualified C.I.

Prepared By:

Noted by:

Concurred by:

Concurred by:

Approved by:

RIZALYN G. QUIONES
Signature over printed name of student

MARISOL GARCIA-MANIPOL, RN, MAN

Signature over printed name of Clinical
Coordinator
Date Signed: __________
Degree: BSN, MAN
a.) PRC NO: 0296870
Valid Until: September 2012
b.) PNA NO: 013487
Valid Until: October 31, 2010

JOSEPHINE B. LEONARDO, RN, Ph. D.

Signature over printed name of Chief Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 0081174
Valid Until: April 3, 2011
b.) PNA NO: 15614
Valid Until: Lifetime

ARLENE GALANG-GENEROSA, RN, MAN

Signature over printed name of Chief Nurse
Date Signed: _______
Degree: BSN, MAN
a.) PRC NO: 152240
Valid Until: October 19, 2011
b.) PNA NO: 18248
Valid Until: Lifetime

NELIA R. CAPULONG, RN, RM, MAN

Signature over printed name of Dean
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0041904
Valid Until: July 31, 2012
b.) PNA NO: 18698
Valid Until: Lifetime
c.) ADPCN NO: 0627
Valid Until: December 2010

Supervised by:
CECILE F. GUEVARRA, RN, MAN
Signature over printed name of Faculty
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0293775
Valid Until: March 13, 2013
b.) PNA NO: 18471
Valid Until: Lifetime

OUR LADY OF FATIMA UNIVERSITY

#1 Esperanza St. Hilltop Mansion Heights, Lagro, Quezon City
Name of Student: QUIONES RIZALYN GUNDRAN________________________________________________________________________________________________________________________________
Name and Address of School: OUR LADY OF FATIMA UNIVERSITY, #1 ESPERANZA ST. HILLTOP MANSION HEIGHTS, LAGRO, QUEZON CITY____________________________________________________
Accreditation Level (if any): PACUCOA LEVEL II__________________________Year Granted: APRIL 10, 2002_________________________________________________________________________________
Date School/Program was Recognized: APRIL 25, 2001____________________Number: 033____________________________
Year: 2001__________________________________________________
First Course (if any): BS ACCOUNTANCY__________________School Graduated From: MANUEL L. QUEZON UNIVERSITY
Year: 1995__________________________________________________
Year of Admission in the Bachelor of Science in Nursing Program: 2006__________________________________________________________________________________________________________________
Year Graduated (BSN Program): MARCH 2010____________________________________________________________________________________________________________________________________
No.
1.

2.

3.

4.

5.

Case No.

Date Performed

Name of Baby

Gender of Baby

165426-B

August 06, 2008

Baby Boy Castillo

Male

167824-B

September 04, 2008

Baby Boy Delfino

169269-B

September 10, 2008

375770

375958

V. Cord Dressing
Name of Mother

Age

Name of Hospital

Supervised by: Qualified C.I.

Rosette Castillo

19

Novaliches District Hospital

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

Male

Magdalene Delfino

17

Novaliches District Hospital

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

Baby Girl Cabel

Female

Mary Ann Cabel

23

Novaliches District Hospital

Rosanie Moro, RN, Ph. D.

PRC NO: 664911
PNA NO: 002436

March 03, 2010

Baby Boy Recto

Male

Rosebelle
Ronquillo

21

General Gregorio H. Del

Pilar District Hospital

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

March 09, 2010

Baby Girl Rivera

Female

Maricel De Guzman

27

General Gregorio H. Del

Pilar District Hospital

Cecile F. Guevarra, RN, MAN

PRC NO: 0293775
PNA NO: 18471

Signature of Qualified C.I.

Prepared By:

Noted by:

Concurred by:

Concurred by:

Approved by:

RIZALYN G. QUIONES
Signature over printed name of student

MARISOL GARCIA-MANIPOL, RN, MAN

Signature over printed name of Clinical
Coordinator
Date Signed: __________
Degree: BSN, MAN
a.) PRC NO: 0296870
Valid Until: September 2012
b.) PNA NO: 013487
Valid Until: October 31, 2010

JOSEPHINE B. LEONARDO, RN, Ph. D.

Signature over printed name of Chief Nurse
Date Signed: ___________
Degree: BSN, MAN
a.) PRC NO: 0081174
Valid Until: April 3, 2011
b.) PNA NO: 15614
Valid Until: Lifetime

ARLENE GALANG-GENEROSA, RN, MAN

Signature over printed name of Chief Nurse
Date Signed: _______
Degree: BSN, MAN
a.) PRC NO: 152240
Valid Until: October 19, 2011
b.) PNA NO: 18248
Valid Until: Lifetime

NELIA R. CAPULONG, RN, RM, MAN

Signature over printed name of Dean
Date Signed: ____________
Degree: BSN, MAN
a.) PRC NO: 0041904
Valid Until: July 31, 2012
b.) PNA NO: 18698
Valid Until: Lifetime
c.) ADPCN NO: 0627
Valid Until: December 2010

Supervised by:
ROSANIE MORO, RN, Ph. D.
Signature over printed name of Faculty
Date Signed: ____________
Degree: BSN, Ph. D.
a.) PRC NO: 664911
Valid Until: November 8, 2012
b.) PNA NO: 002436
Valid Until: October 2010