Bukidnon State University: DR Actual
Bukidnon State University: DR Actual
Bukidnon State University: DR Actual
COLLEGE OF NURSING
Fortich St. Malaybalay, Bukidnon 8700
Tel (088) 221 2196, Fax (088) 813 2717
www.bsc.edu.ph
Delivery Room/Pediatric Cases (NCM 101 and NCM 102 Cases)
Hospital/Home/Lying in Clinic/Municipality/Province
DR Actual
Date Performed and Time
of Delivery
Patients
Initial Only
Case
Number
October 28,2014,8:13AM
January 25,2015,3:53PM
February 13,2015,2:08PM
RAAN
JDN
MAL
20140010056
20150000951
20150001672
Supervised By Clinical
Instructor
(Name and Signature)
Beulah Joy K. Damasco RN,
MAN
Fatima C. Tanzo RN, MN
Fatima C. Tanzo RN, MN
HOSPITAL
BPMC
BPMC
BPMC
Newborn Care
Noted By:
DR Assist
Date Performed and Time of
Delivery
Patients
Initial
Only
Case
Number
Supervised By Clinical
Instructor
(Name and Signature)
HOSPITAL
August 1,2014,10:06AM
November20,2014,10:30A
M
December20,2014,1:33PM
AUT
LER
20140006522
20140011348
BPMC
BPMC
CBC
20140012103
Zennat A. Bayon
BPMC
Bernarda C. Lleno, DM
Dean, College of Nursing
PRC I.D. No. ________________ Valid Until ________
Date Signed: _________________ Time: _____________
Highest Nursing Degree Earned: Masters of Arts in Nursing
PNA Number: ________________ Until Lifetime
ADPCN: ___________________ Valid Until ___________