Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

ESSENTIAL IMMEDIATE CARE OF THE NEWBORN in _______________________ D.R.

FORM IMMEDIATE CARE


OF THE NEWBORN FORM

Prepared by:

Patient’s INITIALS
Date Performed And Procedure Performed Supervised By Clinical Instructor
Time Started Case Number Staff on Duty

03-22-2024 C.P Normal Spontaneous Vaginal


10:45 PM 5674654 Delivery JUAN P. LUNA, RM NADINE LAU, RN, MAN

SUBSCRIBE AND SWORN TO before this day


Clinical Coordinator Dean
PRC No.: PRC No.: 0246099 Affiant exhibiting to me his/her Community Tax Certification No.
Valid Until: January 21, 2027 Valid Until: February 12, 2025 Issued at on
PNA No. PNA no
Valid Until: December 31, 2024 Valid Until: Life
Member ADPCN no.:
Valid Until: AY 2024 - 2025
Notary Public

You might also like