REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION BOARD OF NURSING Prepared by: Name of Student: BIELZA, KATHLEEN NIWREN

FAY CABALANG Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila 1008 Accreditation Level : Level II PAASCU Re-Accredited Number : 66 Year Granted :May 6, 2005 Year : 1958 Not Applicable

Date School / Program was Recognized : April 10, 1958 First Course (if any) : None 2007

School Graduated from :

Year of Admission in the Bachelor of Science in Nursing Program: Year Graduate (BSN Program) : 2011

I. ACTUAL DELIVERIES N o. Case No. Diagnosis Name of Mother Ag e Date of Delivery Time of Delivery Gender of Baby Name of Hospital Type of Delivery Supervised by (Name & Signature of Qualified Clinical Instructor) Dhonna C. Cambe RN, MAN

44755 3

Gravida 4 Parity 3, Pregnancy Uterine 38 weeks age of gestation, cephalic in labor

Virginia Viluz

34

September 15 2009

1:55PM

Female

Dr. Jose Reyes Memorial Hospital

Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

33621 1 51933 2 110906 111977

Gravida 2 Parity1, Pregnancy uterine 31 4/7 weeks age of gestation, cephalic in labor Gravida 1 Parity 0, Pregnancy uterine 38 weeks age of gestation, cephalic in labor Gravida 3 Parity 2, Pregnancy uterine 40 - 41 weeks age of gestation, cephalic in labor Gravida 1 Parity 0, Pregnancy uterine 39 40 weeks age of gestation, cephalic in labor

Olivia Santos Maria Chavez Leny Icaranom Maldie Julanillo

25

October 13 2009 October 14 2009 January 2 2011

11:30 PM

Male

Dr. Jose Reyes Memorial Hospital Dr. Jose Reyes Memorial Hospital Cristina S. Velasquez Lying In clinic Cristina S. Velasquez Lying In clinic

Dhonna C. Cambe RN, MAN Dhonna C. Cambe RN, MAN

31

10:14 PM

Female

26

3:15AM

Male

Remielie Jhoy A. Rando RN, MAN Remielie Jhoy A. Rando RN, MAN

19

January 31 2011

11:35PM

Male

Noted by:

Concurred by:

Concurred by:

Approved by:

ELIZABETH F. HACIAS, RN, RM, MAN GLENDA S. ARQUIZA, RN, PhD,_________ Signature over printed Name of Clinical Coordinator Signature over printed Name of Dean

ELSIE I. SARABIA RN MAN Signature over printed name of Chief Nurse

CRISTINA S. VELASQUEZ RM

_____

Signature over printed name of owner/administrator

Date Signed: Date Signed: Date Signed: ____ Date Signed: ________ Degree: Master of Arts in Nursing Degree: Master of Arts in Nursing Degree:Graduate in Midwifery ____ Degree: Doctor in Philosophy in Education a.) PRC No.: 0101726 a.) PRC No.:0051967 a.) PRC No.: 85157 ____ a.) PRC No.: 0043483 ________ Valid until: July 1, 2011 Valid until: October 2012 Valid until: December 2013 ____ Valid until: _December 31, 2014 ________ b.) PNA No.: 4870 b.) PNA No.: 14415 b.) PNA No.: IMAP No. 3407 ____ b.) PNA No.: 19071 ________ Valid until: Lifetime Valid until: lifetime Valid until: December 31 2011 ____ Valid until: Lifetime ________ c.) ANSAP No.: 0164 c.) ADPCN No.: 0786 ________ Valid until: March 2011 Valid until: December 31, 2011 ________

REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION BOARD OF NURSING Prepared by: Name of Student: BIELZA, KATHLEEN NIWREN FAY CABALANG Name and Address of School: Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila 1008 Accreditation Level: Level II PAASCU Re-Accredited Number: 66 Year Granted :May 6, 2005 Year : 1958 Not Applicable

Date School / Program was Recognized: April 10, 1958 First Course (if any) : None 2007

School Graduated from :

Year of Admission in the Bachelor of Science in Nursing Program: Year Graduate (BSN Program) : 2011

I. DELIVERIES ASSISTED N o. 1 Case No. 0311318 9 51910 4 Diagnosis Name of Mother Mary Grace Manalo Esmeralda Gonzales Ag e Date of Delivery September 16 2009 Time of Delivery Gender of Baby Name of Hospital Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Supervised by (Name & Signature of Qualified Clinical Instructor) Dhonna C. Cambe RN, MAN

Gravida 3 Parity 2, Pregnancy Uterine 38 39 weeks age of gestation, cephalic in labor Gravida 2 Parity 1, Pregnancy Uterine 37 38 weeks age of gestation, cephalic in Labor

30

4:58PM

Female

Dr. Jose Reyes Memorial Hospital Dr. Jose Reyes Memorial Hospital

29

October 14 2009

4:06AM

Male

Dhonna C. Cambe RN, MAN

41248 7

Gravida 1 Parity 0, Pregnancy uterine 39 weeks age of gestation, cephalic in Labor

Eunice baniquit Perez Rubyline Bustilla

23

October 7 2009

9:34 PM

Male

Valenzuela Medical Center

Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

Vilma S. Vasquez RN, MAN

11 1951

Gravid 4 Parity 3, Pregnancy Uterine 39 weeks age of gestation, cephalic in labor

30

January 21 2011

10:20 PM

Female

Cristina S Velasquez lying in clinic

Remielie Jhoy A. Rando RN, MAN

11 1958

Gravid 1 Parity 0, Pregnancy Uterine 40 - 41weeks age of gestation, cephalic in labor

Maricel Robel

20

January 23 2011

11: 40PM

Male

Cristina S Velasquez lying in clinic

Remielie Jhoy A. Rando RN, MAN

Noted by:

Concurred by:

Concurred by:

Concurred by:

Approved by:

ELIZABETH F. HACIAS, RN, RM, MAN ELSIE I. SARABIA RN MAN DONA D. SALMOS RN MAN CRISTINA S. VELASQUEZ RM GLENDA S. ARQUIZA, RN, PhD, _______ Signature over printed Name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Chief Nurse Signature over printed name of owner/administrator Signature over printed Name of Dean Date Signed: Date Signed: Date Signed: Date Signed: Date Signed: _______ Degree: Master of Arts in Nursing Degree: Master of Arts in Nursing Degree: Master of Arts in Nursing Degree: Graduate in Midwifery Degree: Doctor in Philosophy in Education a.) PRC No.: 0101726 a.) PRC No.: 0051967 a.) PRC No.: 0102232 a.) PRC No.: 85157 a.) PRC No.: 0043483 _______ Valid until: July 1, 2011 Valid until: October 2012 Valid until: December 2013 Valid until: December 2013 Valid until: _December 31, 2014_______ b.) PNA No.: 4870 b.) PNA No.: 14415 b.) PNA No.: 19823 b.) PNA No.: IMAP No. 3407 b.) PNA No.: 19071 _______ Valid until: Lifetime Valid until: March 2011 Valid until: Lifetime Valid until: December 31 2011 Valid until: Lifetime _______ c.) ANSAP No.: 0164 ADPCN No.: 0786 _______ Valid until: March 2011 Valid until: December 31, 2011 _______

REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION BOARD OF NURSING Prepared by: Name of Student: BIELZA, KATHLEEN NIWREN FAY CABALANG Name and Address of School: Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila 1008 Accreditation Level: Level II PAASCU Re-Accredited Number: 66 Year Granted: May 6, 2005 Year: 1958

Date School / Program was Recognized: April 10, 1958

First Course (if any) :

None 2007

School Graduated from :

Not

Applicable

Year of Admission in the Bachelor of Science in Nursing Program: Year Graduate (BSN Program: 2011

V. CORD DRESSING No . Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital Supervised by (Name & Signature of Qualified Clinical Instructor)

513252

September 14 2009

Baby Boy Alcantara

Male

Rowena Alcantara

37

Dr. Jose Reyes Memorial Hospital Dr. Jose Reyes Memorial Hospital Dr. Jose Reyes Memorial Hospital

Dhonna C. Cambe RN, MAN

512966

September 15 2009

Baby Boy Ranon

Male

Cherrie Rose Ranon

19

Dhonna C. Cambe RN, MAN

5193097

October 14 2009

Baby Boy Pedimome

Male

Limmy Pedimome

26

Dhonna C. Cambe RN, MAN

142839

October 6, 2009

Baby Girl Pascual

Female

Ediza Sacay pascual

35

Valenzuela Medical Center Cristina S. Velasquez Lying in Clinic

Vilma S. Vasquez RN, MAN

11 1905

January 1, 2011

Baby Boy De Leon

Male

Mariza De Leon

22

Remielie Jhoy A. Rando RN, MAN

Noted by:

Concurred by:

Concurred by:

Concurred by:

Approved by:

ELIZABETH F. HACIAS, RN, RM, MAN ELSIE I. SARABIA RN MAN DONA D. SALMOS RN MAN CRISTINA S. VELASQUEZ RM _____ GLENDA S. ARQUIZA, RN, PhD_________, Signature over printed Name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Chief Nurse Signature over printed name of owner/administrator Signature over printed Name of Dean Date Signed: Date Signed: Date Signed: Date Signed: _____ Date Signed: _______ Degree: Master of Arts in Nursing Degree: Master of Arts in Nursing Degree: Master of Arts in Nursing Degree: Graduate in Midwifery _____ Degree: Doctor in Philosophy in Education a.) PRC No.: 0101726 a.) PRC No.: 0051967 a.) PRC No.: 0102232 a.) PRC No.: 85157 _____ a.) PRC No.: 0043483 _______ Valid until: July 1, 2011 Valid until: October 2012 Valid until: December 2013 Valid until: December 2013 _____ Valid until: _December 31, 2014_________ b.) PNA No.: 4870 b.) PNA No.: 14415 b.) PNA No.: 19823 b.) PNA No.: IMAP No. 3407 _____ b.) PNA No.: 19071 _______ Valid until: Lifetime Valid until: lifetime Valid until: Lifetime Valid until: December 31 2011 _____ Valid until: Lifetime _______ c.) ANSAP No.: 0164 c.) ADPCN No.: 0786 _______ Valid until: March 2011 Valid until: December 31, 2011 _______

REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION BOARD OF NURSING Prepared by: Name of Student: BIELZA, KATHLEEN NIWREN FAY CABALANG Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila 1008 Accreditation Level : Level II PAASCU Re-Accredited Number : 66 Year Granted :May 6, 2005 Year : 1958 Not Applicable

Date School / Program was Recognized : April 10, 1958 First Course (if any) : None 2007

School Graduated from :

Year of Admission in the Bachelor of Science in Nursing Program : Year Graduate (BSN Program) : 2011

I. MINOR OPERATIONS N o. Date of Operatio n Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesi a Name of Surgeon Name of Hospital Name of O.R Scrub Nurse Supervised by (Name & Signature of Qualified Clinical Instructor)

June 23, 2010

00016 1-11

Felix Romero Cameron

Lacerated wound upper eyelid right secondary to mauling lacerated wound earlobe left Lacerated wound Left temporroccipital area secondary to fall

Suturing

Local Anesthesia

Bing Mallari MD

Far Eastern University Nicanor Reyes Medical Foundation Far Eastern University Nicanor Reyes Medical Foundation

Aries Lagmay RN

Jerome A. Domingo RN, MAN

June 29, 2010 December 21, 2010 December 21, 2010

00016 1-21

Maria Taneda

Suturing

Local Anesthesia

Jeremy Tan MD Michelle Luciano MD Edwin Bernardo MD Edwin Bernardo MD

Aries Lagman RN

Jerome A. Domingo RN, MAN

74091 2 66725 3

Arcenio C. Jesena Jose Emmanuel O. Calma

Diabetes Mellitus Status post transmetatarsal disarticulation

Debridement and wound closure right foot Incision and drainage debridement

IV Sedation Local Anesthesia

The Medical City

Mary Ruth Oracion RN Mayr Ruth Oracion RN

Zhenya F. Lim RN, MAN

Abscess second digit right hand

The Medical City

Zhenya F. Lim RN, MAN

December 22, 2010

30262 7

Praxedes C. Bernardo

Non healing wound with cellulitis

Debridement and Incision Biopsy soft tissue right forearm

Local Anesthesia

The Medical city

Ashley flores RN

Zhenya F .Lim RN, MAN

Noted by:

Concurred by:

Concurred by:

Approved by:

ELIZABETH F. HACIAS, RN, RM, MAN MERCEDES E. LEGARDA RN, PhD CRISTELA A. VILLAREAL RN MAN GLENDA S. ARQUIZA, RN, PhD, Signature over printed Name of Clinical Coordinator Signature over printed name of Chief Nurse Signature over printed name of Chief Nurse Signature over printed Name of Dean Date Signed: Date Signed: Date Signed: Date Signed: Degree: Master of Arts in Nursing Degree: Doctor of Philosophy Degree: Master of Arts in Nursing Degree: Doctor in Philosophy in Education a.) PRC No.: 0101726 a.) PRC No.: 054088 a.) PRC No.: 0052490 a.) PRC No.: 0043483 Valid until: July 1, 2011 Valid until: September 24 2011 Valid until: August 14 2012 Valid until: _December 31, 2014 b.) PNA No.: 4870 b.) PNA No.: 2011-069608 b.) PNA No.: 040971 b.) PNA No.: 19071 Valid until: Lifetime Valid until: October 31, 2011 Valid until: October 31 2011 Valid until: Lifetime c.). ANSAP No: 0271 c.). ANSAP No: 01790 c.) ADPCN No.: 0786 Valid until: Lifetime Valid until: Lifetime Valid until: December 31, 2011

REPUBLIC OF THE PHILIPPINES PROFESSIONAL REGULATION COMMISSION BOARD OF NURSING Prepared by: Name of Student: BIELZA, KATHLEEN NIWREN FAY CABALANG Name and Address of School: Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila 1008 Accreditation Level: Level II PAASCU Re-Accredited Number: 66 Year Granted: May 6, 2005 Year: 1958 Not Applicable

Date School / Program was Recognized: April 10, 1958 First Course (if any): None 2007

School Graduated from:

Year of Admission in the Bachelor of Science in Nursing Program: Year Graduate (BSN Program): 2011

I. MAJOR OPERATIONS N o. Date of Operation Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of O.R Scrub Nurse

Supervised by (Name & Signature of Qualified Clinical Instructor)

December 21 2010

6661 05

Nelia S. Soriano

Pseudophakia left eye

Phacoemulsification with Posterior chamber intraocular lens implantation left eye

Local Anesthesia

Alexander Reyes MD Maria Vanessa De Villa MD

The Medical City The Medical City

Jennifer Quinto RN

Zhenya F. Lim RN, MAN

December 21 2010

7462 93

Arturo M. Franco

Hepatocellular carcinoma with lung metastasis

Exploratory laparotomy cholecystectomy intraopertaive ultrasound with liver biopsy

General Endotracheal Anesthesia

Nipsirc Hari RN

Zhenya F. Lim RN ,MAN

December 22 2010

6671 98

Juan S. Ballesteros

Pseudophakia Right Eye

Phacoemulsification with Posterior chamber intraocular lens implantation right eye

Local Anesthesia

Alexander Reyes MD

The Medical City The Medical City

Angela Cera RN

Zhenya F. Lim RN, MAN

December 22, 2010

7461 25

Samuel g. Presado

Bicondylar tibial plateau fracture left

Open treatment of tibial fracture, proximal (tibial plateau) bicondylar with tibial fixation left

Continuous spinal epidural anesthesia

Jose Miguel Lumawig MD

Sherwin De Mesa RN

Zhenya F. Lim RN, MAN

December 22 2010

7465 95

Julius Erico S.P Nolasco

Medial Meniscus tear Right Knee

Arthroscopy knee surgical with minisectomy medial right

Spinal Anesthesia

Silvino Panganiban MD

The Medical City

Mary Ruth Oracion RN

Zhenya F. Lim RN, MAN

Noted by: ELIZABETH F. HACIAS, RN, RM, MAN Signature over printed Name of Clinical Coordinator Name of Dean Date Signed: Degree: Master of Arts in Nursing Philosophy in Education a.) PRC No.: 0101726 Valid until: July 1, 2011 b.) PNA No.: 4870 Valid until: Lifetime

Concurred by: CRISTELA A. VILLAREAL RN MAN Signature over printed name of Chief Nurse Date Signed: Degree: Master of Arts in Nursing

Approved by: GLENDA S. ARQUIZA, RN, PhD, Signature over printed Date Signed: Degree: Doctor in a.) PRC No.: 0043483 Valid until: _December 31, 2014 b.) PNA No.: 19071 Valid until: Lifetime c.) ADPCN No.: 0786 Valid until: December 31,

a.) PRC No.: 0052490 Valid until: August 14 2012

b.) PNA No.: 040971 Valid until: October 31 2011

2011

c.). ANSAP No: 01790 Valid until: Lifetime