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    Denyliza Ricardo Ediong
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    This document contains two copies of an ODC Form 2A for Benguet State University. The form is used to document surgical scrubs performed at either Benguet General Hospital or Baguio General Hospital and Medical Center. It requests information such as the student's name and signature, date and time of the scrub, patient initials, case number, surgical procedure, supervising staff and their signatures. It also documents the approvals and credentials of the clinical coordinator and dean who oversee the program.

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    This document contains two copies of an ODC Form 2A for Benguet State University. The form is used to document surgical scrubs performed at either Benguet General Hospital or Baguio General Hospital and Medical Center. It requests information such as the student's name and signature, date and time of the scrub, patient initials, case number, surgical procedure, supervising staff and their signatures. It also documents the approvals and credentials of the clinical coordinator and dean who oversee the program.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    13 views3 pages

    Major

    Uploaded by

    Denyliza Ricardo Ediong
    This document contains two copies of an ODC Form 2A for Benguet State University. The form is used to document surgical scrubs performed at either Benguet General Hospital or Baguio General Hospital and Medical Center. It requests information such as the student's name and signature, date and time of the scrub, patient initials, case number, surgical procedure, supervising staff and their signatures. It also documents the approvals and credentials of the clinical coordinator and dean who oversee the program.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
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    ODC Form 2A

    BENGUET STATE UNIVERSITY


    La Trinidad, Benguet, 2601 Philippines Phone number: 309-3882; Fax number: 422-2281; E-mail:ents3@yahoo.com; Web site:www.bsu.edu.ph LEVEL III RE-ACCREDITED,AACCUP,December 1,2007- November 3, 2011
    SURGICAL SCRUB in BENGUET GENERAL HOSPITAL Prepared by: Printed Name with Signature of Student Date Performed and Time Started Patient INITIALS (only) Case Number

    O.R. SCRUB FORM Major

    SURGICAL PROCEDURE PERFORMED

    O.R. Nurse On Duty (Name AND Signature)

    SUPERVISED BY: Clinical Instructor Name and Signature

    Noted by: LAWRENCE C. CARANTO,RN Clinical Coordinator, PRC I.D No.: 0311507 Valid Until : September 11,2012 PNA No.: 2012-024526 Valid Until: December 31,2012 Date signed: Time signed : Highest Nursing Degree Earned: Master of Arts in Nursing ( MAN)

    Approved by: VICENTE G.PANAGAN JR.,RN Dean, PRC I.D. No. 0296633 PNA No.: 2012-024527 ADPCN NO.: 11-036 Date signed: Specify Highest Nursing Degree Earned: Valid Until: April 11,2014 Valid Until: December 31,2012 Valid Until: December 31,2012 Time signed:

    ODC Form 2A

    BENGUET STATE UNIVERSITY


    La Trinidad, Benguet, 2601 Philippines Phone number: 309-3882; Fax number: 422-2281; E-mail:ents3@yahoo.com; Web site:www.bsu.edu.ph LEVEL III RE-ACCREDITED,AACCUP,December 1,2007- November 3, 2011
    SURGICAL SCRUB in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City Prepared by: Printed Name and Signature of Student: Date Performed and Time Started Patient INITIALS (only) Case Number

    O.R. SCRUB FORM Major

    SURGICAL PROCEDURE PERFORMED

    O.R. Nurse On Duty (Name AND Signature)

    SUPERVISED BY: Clinical Instructor Name and Signature

    Noted by: LAWRENCE C. CARANTO,RN Valid Until : September 11,2012 Clinical Coordinator, PRC I.D No.: 0311507 PNA No.: 2012-024526 Valid Until: December 31,2012 Date signed: Time signed : Highest Nursing Degree Earned: Master of Arts in Nursing ( MAN)

    Approved by: VICENTE G.PANAGAN JR.,RN Dean, PRC I.D. No. 0296633 PNA No.: 2012-024527 ADPCN NO.: 11-036 Date signed: Specify Highest Nursing Degree Earned: Valid Until: April 11,2014 Valid Until: December 31,2012 Valid Until: December 31,2012 Time signed:

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