Professional Documents
Culture Documents
Ass 1-2 CL
Ass 1-2 CL
Ass 1-2 CL
La Salle
College of Nursing
La Salle Avenue, Bacolod City 6100
Tel. #: 434-4010
Name of Student: Gargar, Larry Jun Sumbi First Course (If any) : NA
Date School/Program was Recognized: June 14, 1983 School Graduated From: NA
Accreditation Level: NA Year of Admission in the BSN Program:
Year Graduated from the BSN Program:
I. MAJOR SCRUBS
Type of
Time Time Date of
No. Case No. Name of Patient Operation Performed Anesthesi
Started Ended Operation
a
3 01:25 PM 02:50 PM 07-20-10 1042218 Canson, Aileen Cleft Lip Repair General
Larry Jun S. Gargar Leo G. Lozana, RN Jean E. Javier, RN, MN Josephine L. de la Serna, RN, MN
Examinee Clinical Instructor Clinical Supervisor Dean
CTC Number: Date Signed: Date Signed: Date Signed:
Date: Degree: RN Degree: RN, MN Degree: RN, MN
Place: a) PRC No: 0351138 a) PRC No: 0087213 a) PRC No: 0037515
Valid Until: 10-05-13 Valid Until: 10-06-12 Valid Until: 06-03-14
b) PNA No: b) PNA No: 039802 b) PNA No: 10408
Valid Until: Valid Until: 10-31-11 Valid Until: Lifetime
NA Year: NA
NA
Year of Admission in the BSN Program: 2007
Year Graduated from the BSN Program: 2011
MAJOR SCRUBS
Name of Surgeon Name of Hospital
Concurred by:
Name of Student:
Gargar, Larry Jun Sumbi First Course (If any) : NA
Date School/Program was Recognized: June 14, 1983 School Graduated From: NA
Accreditation Level: NA Year of Admission in the BSN Program
Year Graduated from the BSN Program
Larry Jun S. Gargar Mariles L. Ruiz, RN, MAN Jean E. Javier, RN, MN Josephine L. de la Serna, RN,
Examinee Clinical Instructor Clinical Supervisor Dean
CTC Number: Date Signed: Date Signed: Date Signed:
Date: Degree: RN, MAN Degree: RN, MN Degree: RN, MN
Place: a) PRC No: 0209363 a) PRC No: 0087213 a) PRC No: 0037515
Valid Until: 12-17-11 Valid Until: 10-06-12 Valid Until: 06-03-14
b) PNA No: 055333 b) PNA No: 039802 b) PNA No: 10408
Valid Until: 10-31-11 Valid Until: 10-31-11 Valid Until: Lifetime
NA Year: NA
NA
Year of Admission in the BSN Program: 2007
Year Graduated from the BSN Program: 2011
NOR SCRUBS
Name of Surgeon Name of Hospital
Concurred by:
f St La Salle Clinic
University Of St. La Salle
College of Nursing
La Salle Avenue, Bacolod City 6100
Tel. #: 434-4010
Name of Student:
Gargar, Larry Jun Sumbi First Course (If any) : NA
Date School/Program was Recognized: June 14, 1983 School Graduated From: NA
Accreditation Level: NA Year of Admission in the BSN Program:
Year Graduated from the BSN Program:
Larry Jun S. Gargar Ellen P. Cartagena RN, MN Jean E. Javier, RN, MN Josephine L. de la Serna, RN, MN
Examinee Clinical Instructor Clinical Supervisor Dean
CTC Number: Date Signed: Date Signed: Date Signed:
Date: Degree: RN,MN Degree: RN, MN Degree: RN, MN
Place: a) PRC No: 0212751 a) PRC No: 0087213 a) PRC No: 0037515
Valid Until: 10-24-11 Valid Until:10-06-12 Valid Until: 06-03-14
b) PNA No: b) PNA No: 039802 b) PNA No: 10408
Valid Until: Valid Until:10-31-11 Valid Until: Lifetime
CLMMRH NSVD
CLMMRH NSVD
Concurred by:
Name of Student:
Gargar, Larry Jun Sumbi First Course (If any) : NA
Date School/Program was Recognized: June 14, 1983 School Graduated From: NA
Accreditation Level: NA Year of Admission in the BSN Program:
Year Graduated from the BSN Program:
Larry Jun S. Gargar Ellen P. Cartagena RN, MN Jean E. Javier, RN, MN Josephine L. de la Serna, RN, MN
Examinee Clinical Instructor Clinical Supervisor Dean
CTC Number: Date Signed: Date Signed: Date Signed:
Date: Degree: RN,MN Degree: RN, MN Degree: RN, MN
Place: a) PRC No: 0212751 a) PRC No: 0087213 a) PRC No: 0037515
Valid Until: 10-24-11 Valid Until: 10-06-12 Valid Until: 06-03-14
b) PNA No: b) PNA No: 039802 b) PNA No: 10408
Valid Until: Valid Until: 10-31-11 Valid Until: Lifetime
2007
2011
CLMMRH NSVD
CLMMRH NSVD
Concurred by:
Name of Student: Gargar, Larry Jun Sumbi First Course (If any) : NA Year: NA
Date School/Program was Recognized: June 14, 1983 School Graduated From: NA
Accreditation Level: NA Year of Admission in the BSN Program: 2007
Year Graduated from the BSN Program: 2011
V. CORD DRESSING
No. Case No. Date Performed Time of Delivery Gender of Baby Name of Mother Age Name of Hospital
Prepared by: Supervised by: Noted by: Approved by: Concurred by:
Larry Jun S. Gargar Arlene T. Conlu, RN, MN Jean E. Javier, RN, MN Josephine L. de la Serna, RN, MN Edelina I. Javellana, RN, MAN
Examinee Clinical Instructor Clinical Supervisor Dean Chief Nurse
CTC Number: Date Signed: Date Signed: Date Signed: Date Signed:
Date: Degree: RN,MN Degree: RN, MN Degree: RN, MN Degree: RN,MAN
Place: a) PRC No: 0284069 a) PRC No: 0087213 a) PRC No: 0037515 a) PRC No: 0140661
Valid Until: 01-11-12 Valid Until: 10-06-12 Valid Until: 06-03-14 Valid Until:04-05-13
b) PNA No: b) PNA No: 039802 b) PNA No: 10408 b) PNA No: 055512
Valid Until: Valid Until: 10-31-11 Valid Until: Lifetime Valid Until:
10-31-11
CORD DRESSING
Name of Hospital
BOLMSH
RN,MAN
0140661
04-05-13
055512
10-31-11