DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.

COLLEGE OF NURSING
Calanipawan Road, Calanipawan, Tacloban City, Leyte 6500, Philippines
Tel. Nos. (053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053)327-5004, E-mail address: rtr1980@yahoo.com

MAJOR SCRUBS in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte
Prepared by: JONATHAN A. RAMO
PATIENT’S
DATE PERFORMED
INITIALS
OPERATION PERFORMED NURSE ON DUTY SUPERVISED BY CLINICAL INSTRUCTOR
TIME STARTED to CASE
TIME ENDED NUMBER

April 27, 2021 S.N.M.

Thyroid Lobectomy, Right with Isthmusectomy REYNALD DAVEN. G. BALANO, RN, MAN MARK ANGELO T. CRISTINO, MAN, RN
10:33 AM to 1:36 PM 307182

May 24, 2021 G.A.T. Emergency repeat Cesarean Section with Intra-
JEANNE MARIE C. SARMIENTO, RN TATYANA LAUREN P. AJERO, MAN, RN
5:58 PM to 6:59 PM 310084 Cesarean Section Intrauterine Device Insertion

May 24, 2021 G.A.T. Emergency Repeat Cesarean Section with Intra-
JEANNE MARIE C. SARMIENTO, RN TATYANA LAUREN P. AJERO, MAN, RN
5:58 PM to 6:59 PM 310084 Cesarean Section Intrauterine Device Insertion

Noted by: MR. MARK ANGELO T. CRISTINO, MAN, RN Approved by: DR. SOCORRO SALVACION GASCO, DM-HRM, MN, RN
Clinical Coordinator, College of Nursing Dean, College of Nursing
PRC I.D. No. 0752855 Valid until: August 21, 2021 PRC I.D. No. 0063136 Valid until: June 27, 2022
PNA No. 003008 Valid until: December 31, 2021 PNA No. 1219 Valid until: LIFE MEMBER
Date document is signed: ____________ Time: _________ ADPCN No. 11-192 Valid until: June 2022
Highest Nursing Degree Earned: Masters of Arts in Nursing Date document is signed: ____________ Time: _________
Highest Nursing Degree Earned: Doctor of Management

SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their competence evidence of identities.
 DOÑA REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION, INC.
COLLEGE OF NURSING
Calanipawan Road, Calanipawan, Tacloban City, Leyte 6500, Philippines
Tel. Nos. (053) 321-2345/ 321-4150/ 325-8353/ 327-5634/ 327-1776, Telefax Nos. (053)327-5004, E-mail address: rtr1980@yahoo.com

MAJOR CIRCULATING in EASTERN VISAYAS REGIONAL MEDICAL CENTER, Tacloban City, Leyte
Prepared by: JONATHAN A. RAMO
PATIENT’S
DATE PERFORMED
INITIALS
OPERATION PERFORMED NURSE ON DUTY SUPERVISED BY CLINICAL INSTRUCTOR
TIME STARTED to CASE
TIME ENDED NUMBER
Open Reduction Internal Fixation Plate & Screw
April 26, 2021 M.A.C.T. Fixation of Fibula, Open Reduction Internal
REYNALD DAVEN. G. BALANO, RN, MAN MARK ANGELO T. CRISTINO, MAN, RN
9:58 AM to 12:55 PM 307207 Fixation & Multiple Screw Fixation of Medial
Malleolus, Application of Short Leg Posterior Mold
Open Reduction Internal Fixation Plate & Screw
April 26, 2021 M.A.C.T. Fixation of Fibula, Open Reduction Internal
REYNALD DAVEN. G. BALANO, RN, MAN MARK ANGELO T. CRISTINO, MAN, RN
9:58 AM to 12:55 PM 307207 Fixation & Multiple Screw Fixation of Medial
Malleolus, Application of Short Leg Posterior Mold
Open Reduction Internal Fixation Plate & Screw
April 26, 2021 M.A.C.T. Fixation of Fibula, Open Reduction Internal
REYNALD DAVEN. G. BALANO, RN, MAN MARK ANGELO T. CRISTINO, MAN, RN
9:58 AM to 12:55 PM 307207 Fixation & Multiple Screw Fixation of Medial
Malleolus, Application of Short Leg Posterior Mold

Noted by: MR. MARK ANGELO T. CRISTINO, MAN, RN Approved by: DR. SOCORRO SALVACION GASCO, DM-HRM, MN, RN
Clinical Coordinator, College of Nursing Dean, College of Nursing
PRC I.D. No. 0752855 Valid until: August 21, 2021 PRC I.D. No. 0063136 Valid until: June 27, 2022
PNA No. 003008 Valid until: December 31, 2021 PNA No. 1219 Valid until: LIFE MEMBER
Date document is signed: ____________ Time: _________ ADPCN No. 11-192 Valid until: June 2022
Highest Nursing Degree Earned: Masters of Arts in Nursing Date document is signed: ____________ Time: _________
Highest Nursing Degree Earned: Doctor of Management

SUBSCRIBED AND SWORN to before me this ________________________ at Tacloban City by the above parties who presented their competence evidence of identities.