New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)
Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

I. MAJOR OPERATIONS
No . Date of Operati on Case No. Name of Patient Diagnosis Operation Performed Type of Anesthe sia Name of Surgeon Name of Hospital Name of O.R. Scrub Nurse Signature of O.R. Scrub Nurse

August 11, 2009

1210 33

Renato Cruz

Cataract Senile Mature Left

Extracapsular Cataract Extraction with Intraocular Lens

Local

Dr. Elizabeth O. Tan MD

Mandaluyong City Medical Center

Michael F. Vinco RN

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Concurred by:
TERESITA J. DIMAYACYAC
Chief Nurse Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: 0127552 Valid until: October 2, 2010 b.) PNA No.: 17873 Valid until: Lifetime c.) ANSAP No: 00615 Valid until: December 2010

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Supervised by:
MARILYN M. UBALDO
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0226715 Valid until: February 1, 2012 b.) PNA No.: 033485 Valid until: October 21, 2010

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)

Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

I. MAJOR OPERATIONS
No.
1 2

Date of Operat ion

January 18, 2010 January 20, 2010 January 25, 2010 January 27, 2010

Case No.
90919 2 10049 1 10065 7 10074 6

Name of Patient
Mark Dumlao Ayad Arceli Paguinigan Nobleza Laride Benigno Sayson Benelyn M. Ardina

Diagnosis
Fracture Open Symphisis Mandible Fracture Close, Comminuted Patella Right secondary to fall Acute Appendicitis
G2P1 (1001) Pregnancy Uterine 38 weeks AOG cephalic presentation, Caesarian 1, secondary to failure of descent I labor

Operation Performed
s/p Open Reduction Internal Fixation with Plating, Palatoplasty s/p Open Reduction Internal Fixation (TBW) with screw fixation, Patella Right s/p E Appendectomy
E LTCS delivered to a live baby boy with Apgar Score of 8,9

Type of Anesthe sia

General Spinal

Name of Surgeon
Major Jardiolin Captain Zapanta

Name of Hospital
V. Luna General Hospital V. Luna General Hospital V. Luna General Hospital V. Luna General Hospital

Name of O.R. Scrub Nurse

Captain Caalim Captain Caalim Second Lieutenant Momongan Ms. Ahalajal

Signature of O.R. Scrub Nurse

3 4

Spinal Spinal

Major Terencio Major Fabian

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator

Concurred by:
COLONEL HAIDE S. LEGASPI NC (GSC)
Chief Nurse

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean

Supervised by:

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004) ANELITA R. DELA CRUZ
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: Valid until: b.) PNA No.: Valid until: Lifetime Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: Valid until: b.) PNA No.: Valid until: Lifetime c.) ANSAP No: Valid until: Lifetime Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

II. MINOR OPERATIONS

No . Date of Operat ion Case No. Name of Patient Diagnosis Operation Performed Type of Anesthe sia Name of Surgeon Name of Hospital Name of O.R. Scrub Nurse Signature of O.R. Scrub Nurse

April 27, 2010

1030 90

Andy Abelar

Lacerated Wound, Third Digit, Palmar Hand Right

Suturing

Local

Liza Mae Malixi MD

Mandaluyong City Medical Center

Lilybeth Castulo RN

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:

Concurred by:
TERESITA J. DIMAYACYAC
Chief Nurse Date signed: ______________________

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________

Supervised by:

GEMMA P. LAA
Clinical Coordinator

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004) Date signed: ______________________ Degree: BSN RN MAN Degree: BSN, R.N. MAN MARILYN M. UBALDO
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0226715 Valid until: February 1, 2012 b.) PNA No.: 033485 Valid until: October 31, 2010 Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime a.) PRC No: 0127552 Valid until: October 2, 2010 b.) PNA No.: 17873 Valid until: Lifetime c.) ANSAP No: 00615 Valid until: December 2010

a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

II. MINOR OPERATIONS

No.
1 2

Date of Operat ion

May 2010 May 5, 2010

Case No.
00004 539 14320 7

Name of Patient
Josefina Mariano Gadacho Loreto Bulaon Sangco

Diagnosis
Pterygium Nasal, Left
TCCA of UB T1NxMx s/p TURBT, Intravesical Chemotherapy, Surveillance Cystoscopy LUTS 2 to Urethral Stricture

Operation Performed
Pterygium Excision, Left
Visualized Internal Urethotomy, Surveillance Cystoscopy, Bladder Wash Cytology

Type of Anesthe sia

Local Spinal

Name of Surgeon
Leon Paolo R. Lara MD Karl Marvin Tan MD

Name of Hospital
Veterans Memorial Medical Center Veterans Memorial Medical Center

Name of O.R. Scrub Nurse

Joy Aubrey H. Tinoco RN Michelle I. Nero RN

Signature of O.R. Scrub Nurse

3 4

May 6, 2010 May 7, 2010

19455 4 17171 3

Gregorio Geronca Manongsong Pedro Pablico Palomo

Peri-Anal Abscess t/c Fistula-in-Ano Nephrolithiasis Left s/p ESWL t/c Steinstrasse Left

Fistulotomy, Proctosigmoidosco py with Anoscopy Cystoscopy, Ureteroscopy Left

Spinal Spinal

Galvan MD, Legaspi MD Luis Jake R. Rubio III MD

Veterans Memorial Medical Center Veterans Memorial Medical Center

Elizabeth C. Galang RN Rochlem M. Torralba RN

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Concurred by:
PRISCILLA NANCY A. LASERNA
Chief Nurse Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: 0047612 Valid until: November 14, 2012 b.) PNA No.: 14015 Valid until: Lifetime c.) ANSAP No: 0817 Valid until: Lifetime

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Supervised by:
GEMMA P. LAA
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)

III. ACTUAL DELIVERIES

N o.
1 2 3 4 5

Case No.
873203 889102 196112 916119 914342

Diagnosis
Pregnancy Uterine term size G5P3 Pregnancy Uterine term cephalic in labor G3P2 Pregnancy Uterine term 39 weeks AOG cephalic in labor G3P2 Pre Eclampsia seizure 37 weeks AOG G2P1 Pregnancy Uterine 39 weeks AOG CIL G1P0

Name of Mother
Decano, Rosemarie Itik, Josephine Solomon, Roselyn R. Martinez, Florepin R. Arena, Cheryl A.

Age
45 30 34 26 26

Date of Delivery
May 9, 2010 July 26,2010 December 5, 2010 December 8, 2010 December 18, 2010

Time of Delivery
2:37 PM 9:03 PM 4:49 PM 5:06 AM 10:58 PM

Gend er of Baby
Girl Girl Girl Girl Girl

Name of Hospital
Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital

Type of Delivery
Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Concurred by:
MARILOU GUILLERMINA J. PALAFOX
Chief Nurse Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: 0118849 Valid until: February 10, 2011 b.) PNA No.: 18459 Valid until: Lifetime

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Supervised by:

AMELITA E. MIGUEL
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0166622 Valid until: October 19, 2012 b.) PNA No.: 039112 Valid until: December 31, 2010
Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)
March 20, 2007
First Course, if any:

035
School Graduated From:

2007

NONE June 2007 April 2011

NONE

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

IV. ASSISTED DELIVERIES

N o.
1 2 3 4 5

Case No.
862433 889122 916127 914282 914284

Diagnosis
Pre Eclampsia Pregnancy Uterine 39 weeks AOG cephalic in labor G1P0 Pregnancy Uterine G3P2 cephalic in labor Placenta Previa Totalis PU 23 6/7 weeks AOG G1P0 Pregnancy Uterine 40 weeks AOG G2P1

Name of Mother
Baliwas, Jennifer N. Tagle, Edith H. Ascutia, Leah G. Pacuan, Dina Morales, Maureen A.

Age
29 18 26 21 29

Date of Delivery
July 26,2010 July 27,2010 December 7,2010 December 14,2010 December 14,2010

Time of Delivery
1:54 AM 2:02 AM 5:00 AM 5:54 AM 6:50 AM

Gende r of Baby
Female Male Male Male Female

Name of Hospital
Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital

Type of Delivery
Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Concurred by:
MARILOU GUILLERMINA J. PALAFOX
Chief Nurse Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: 0118849 Valid until: February 10, 2011 b.) PNA No.: 18459 Valid until: Lifetime

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Supervised by:

AMELITA E. MIGUEL
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0166622 Valid until: October 19, 2013 b.) PNA No.: 039112 Valid until: December 31, 2010

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)
Name of Student:

JIMENEZ, WILBUR DANIEL Valdez No. 9 Central Avenue, New Era, Quezon City
Year Granted: Number: School Graduated From: Year:

Name and Address of NEW ERA UNIVERSITY, School: Accreditation Level Date School/Program Was Recognized First Course, if any:

March 20, 2007 NONE June 2007 April 2011

035 NONE

2007

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

V. CORD DRESSING
No .
1 2 3 4 5

Case No.
885078 885079 885145 885375 914357

Date Performed
July 18, 2010 July 18, 2010 July 20, 2010 July 21, 2010 December 14, 2010

Name of Baby
Baby Girl Costes Baby Girl Apolinar Baby Girl Felipe Baby Girl Escobido Baby Girl Arena

Gender of Baby
Female Female Female Female Female

Name of Mother
Costes, Maricar Apolinar, Nora Felipe, Jessica Escobido, Elsa Arena, Cheryl A.

Age
31 39 23 42 26

Name of Hospital
Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital Quezon City General Hospital

New Era University

College of Nursing
Quezon City

(Adopted from Professional Regulation Commission, Board of Nursing Resolution No. 357 , Series of 2004)

Prepared by:
Wilbur Daniel V. Jimenez Student

Noted by:
GEMMA P. LAA
Clinical Coordinator Date signed: ______________________ Degree: BSN, R.N. MAN a.) PRC No.: 0211212 Valid until: February 26, 2014 b.) PNA No.: 17892 Valid until: Lifetime

Concurred by:
MARILOU GUILLERMINA J. PALAFOX
Chief Nurse Date signed: ______________________ Degree: BSN RN MAN a.) PRC No: 0118849 Valid until: February 10, 2011 b.) PNA No.: 18459 Valid until: Lifetime

Approved by:
BABY SIMONNETTE B. LEONCIO
Dean Date signed: ___________________ Degree: BSN, R.N. MAN a.) PRC No.: 0224181 Valid until: May 3, 2010 b.) PNA No.: 053422 Valid until: October 31 2011 c.) ADCPN No.: 0536 Valid until: December 31, 2011

Supervised by:
ANGELINA G. VISAYA
Clinical Instructor Date signed: ______________________ Degree: BSN RN MAN a.) PRC No.: 0081860 Valid until: April 9, 2012 b.) PNA No.: 039111 Valid until: October 31, 2010