Arellano University

NAME OF STUDENT: MORENTE, SONNY MA. HIZOLA ___ College

_______of Nursing
First Course (if any): Not Applicable___ ____ ___
Name of School: Arellano University_____________________
2600 Legarda
___
St. Sampaloc, Manila
School Graduated: Not Applicable____ ___ __
Address of School: 2600 Legarda St. Sampaloc, Manila___ _______ _ Year Admission in the BSN Program: 2005___ _ ___
Recognition and Accreditation Level: PACUCOA Level I Formal (September 16, 2006) ___ Year Graduated from the BSN Program: 2010______ ___
Date when School was Recognized: July 07, 1969_ Number: R.O. 184 Year: 1969_____

I. MAJOR OPERATION
Date of Name of Type of Name of Name of O.R. Supervised by:
No. Case # Diagnosis Operation Performed Name of Surgeon Name and Signature of Qualified
Operation Patient Anesthesia Hospital Scrub Nurse Clinical Instructor

1 07-22-2009 528846 Rubilyn T. La Gravida2 Para1, 37 Weeks Age of Low Transverse Cesarean Section1 Spinal Anesthesia Dr. Conception G. Lat Rizal Provincial Ma. Lourdes C. Quiohilag RN Salvador P. Aquino IV RN, MAN-c
Camfuegan Gestation, Multiple Pregnancy Hospital
Jaquiline W. Gravida2 Para1, 40-41 Weeks Age of Rizal Provincial
2 07-29-2009 528988 Low Transverse Cesarean Section2 Spinal Anesthesia Dr. Maricar Z. Bautista Julia Diosa D. Sta. Maria RN Salvador P. Aquino IV RN, MAN-c
Quinte Gestation, Previous Cesarean1 Hospital

Total Abdominal Hysterectomy with Rizal Provincial

3 07-30-2009 529010 Gina Arresgado Spinal Anesthesia Dr. Evangeline C. Tan Salvador P. Aquino IV RN, MAN-c
Ovarian New Growth Bilateral Salphingo-Oophorectomy Hospital Thelma T. San Juan RN, MAN

12090017 Mark Ronald V. Open Reduction Internal Fixation with Spinal-Epidural

4 12-09-2009 Close Fractured Femur, Left Dr Oliver D. Ferrer Dagupan Doctors
750 Estrada Plating, Left Femur Anesthesia Rowena V. Rosario RN Evelyn S. Cruz RN, MAN-c
Villaflor Hospital

Phacoemulsification with Posterior

12090001 Rodolfo Tomaldan Dagupan Doctors
5 12-10-2008 Cataract, Left Eye Chamber Intraocular Lens Topical Anesthesia Dr. Michael A. Go Evelyn S. Cruz RN, MAN-c
44 Jimenes Villaflor Hospital Rae Amor Q. Santillan RN
Implantation, Left Eye

Concurred by: Concurred by: Supervised by: Supervised by:

ROSALINA R. BERONIO RN, MAN MARIE FE G. DELA CRUZ RN, MAN SALVADOR P. AQUINO IV RN, MAN-c EVELYN S. CRUZ RN, MAN-c
Chief Nurse, Rizal Provincial Hospital Chief Nurse, Dagupan Doctors Villaflor Hospital Clinical Instructor, Rizal Provincial Hospital Clinical Instructor, Dagupan Doctors Villaflor Hospital
Degree: BSN, MAN Date Signed:____________ Degree: BSN, MAN Date Signed:____________ Degree: BSN Date Signed:____________ Degree: BSN Date signed:_______
PRC No. 0066736 Valid Until 06-11-2011 PRC No. 0238673 Valid Until 10-27-2011 PRC No. 0224008 Valid Until 06-17-2011 PRC No. 0190602 Valid Until January 2011
PNA No. 018612 Valid Until Lifetime____ PNA No. 018433 Valid Until Lifetime PNA No. 007380 Valid Until 10-31-2010 PNA No. 014094 Valid Until 10-31-2010
Noted by: Approved by: Legend: Prepared by:

ESTER S. CLIMACO RN, MAN ROBERTO C. SOMBILLO RN, RM, MAN

Overall Clinical Coordinator Dean ________________________________
Degree: BSN, MAN Degree: BSN, MIDWIFERY, MAN SONNY MA. H. MORENTE
PRC No.: 042052 Valid Until: 10-16-2011 PRC No.: 0172832 Valid Until: 08-02-2010 (Student’s Signature over Printed Name)
PNA No.: 4275 Valid Until: Lifetime ADPCN No.: 0779 Valid Until: 2010
PNA No.: 4275 Valid Until: Lifetime
 Arellano University
NAME OF STUDENT: MORENTE, SONNY MA. HIZOLA ____________ __
College of Nursing First Course (if any):________Not Applicable_____________
Name of School: 2600
Arellano University___________________ Legarda
___ St. Sampaloc, Manila
School Graduated:__________ Not Applicable___________
Address of School: 2600 Legarda St. Sampaloc, Manila___ _______ _ Year Admission in the BSN Program:_______2005_________
Recognition and Accreditation Level: PACUCOA Level I Formal (September 16, 2006)___ Year Graduated from the BSN Program:_____2010__________
Date when School was Recognized: July 07, 1969 Number: R.O. No. 184 Year: 1969

II. MINOR OPERATION

Supervised by:
Date of Name of Operation Type of Name of O.R.
No. Case # Diagnosis Name of Surgeon Name of Hospital Name and Signature of Qualified
Operation Patient Performed Anesthesia Scrub Nurse
Clinical Instructor

1 05-18-2009 06-2009- John Philip T. Phimosis Circumcision Local Dr. Elizabeth S. De Guzman SMDH Rey Alvin T. Galicia RN Marita P. Lestor RN, MAN
6585 Fajardo Anesthesia

2 05-19-2009 06-09-6691 Mignonette Labitoria Infected Toe Nail, Left Ungiectomy, Left Toe Local Dr. Raymund Jun P. Raymundo SMDH Marlon R. Calma RN Marita P. Lestor RN, MAN
Nail Anesthesia

3 05-20-2009 06-2009-496 Venus Bunalade Sebaceous Cyst, Right Nipple Excision Biopsy, Right Local Dr. Burton E. Cordero SMDH Rey Alvin T. Galicia RN Marita P. Lestor RN, MAN
Nipple Anesthesia

4 07-30-2009 529006 Rachel T. Brown Abnormal Uterine Bleeding Fractional Dilatation and Spinal Dr. Marizel Ann M. Sucayan RPH Arlene S.M. Marinay RN Salvador P. Aquino IV RN, MAN-c
Curettage Anesthesia
Incomplete Abortion 112/7 Non-
5 02-17-2010 959800 Anna Marie Septic, Non-Induce Gravida1 Parity Complete Curettage IV Sedation Dr. Cecille Marie F. Rabuco Ospital ng Sampaloc Joanne Marie S. Garcia RN, Joanne Marie S. Garcia RN, MAN
Gabrielle 0 MAN

Concurred by: Concurred by: Concurred by: Supervised by: Supervised by: Supervised by:

ARLEENE V. CORONEL RN, MAN ROSALINA R. BERONIO RN, MAN GRACE D. ZALDUA RN, MAN MARITA P. LESTOR RN, MAN SALVADOR P. AQUINO IV RN, MAN-c JOANNE MARIE S. GARCIA RN, MAN
Chief Nurse, SMDH Chief Nurse, RPH OIC, Chief Nurse, Ospital ng Sampaloc Clinical Instructor, SMDH Clinical Instructor, RPH Clinical Instructor, Ospital ng Sampaloc
Degree: BSN, MAN Date Signed:_________ Degree: BSN, MAN Date Signed:_________ Degree: BSN, MAN Date Signed:_______ Degree: BSN, MAN Date Signed:_______ Degree: BSN Date Signed:_______ Degree: BSN, MAN Date Signed:_______
PRC No. 0177796 Valid Until 10-16-2011_ PRC No. 0066736 Valid Until 06-01-2011 PRC No. 0142514 Valid Until 05-26-2012 PRC No. 0153222 Valid Until 06-22-2011 PRC No. 0224008 Valid Until 06-17-2011 PRC No. 0220441 Valid Until June 2012__
PNA No. 017701_ Valid Until 11-31-2010_ PNA No. 018612 Valid Until Lifetime____ PNA No. 015062 Valid Until Lifetime___ PNA No. 006906 Valid Until 10-31-2010 PNA No. 007380 Valid Until 10-31-2010 PNA No. 006838 Valid Until 10-31-2010
Approved by: Legend: Prepared by:
Noted by:

ROBERTO C. SOMBILLO RN, RM, MAN SMDH= San Miguel District Hospital
ESTER S. CLIMACO RN, MAN Dean RPH= Rizal Provincial Hospital ________________________________
Overall Clinical Coordinator Degree: BSN, MIDWIFERY, MAN SONNY MA. H. MORENTE
Degree: BSN, MAN PRC No.: 0172832 Valid Until: 08-02-2010 (Student’s Signature over Printed Name)
PRC No.: 042052 Valid Until: 10-16-2011 ADPCN No.: 0779 Valid Until: 2010
PNA No.: 4275 Valid Until: Lifetime PNA No.: 4275 Valid Until: Lifetime

Arellano University
College of Nursing
2600 Legarda St. Sampaloc, Manila
 NAME OF STUDENT: MORENTE, SONNY MA. HIZOLA __________ First Course (if any): Not Applicable___ ____ ___
School Graduated: Not Applicable____ ___ __
Name of School: Arellano University_________________________
Year Admission in the BSN Program: 2005___ _ ___
Address of School: 2600 Legarda St. Sampaloc, Manila___ _______ _
Year Graduated from the BSN Program: 2010______ ___
Recognition and Accreditation Level: PACUCOA Level I Formal (September 16, 2006)__
Date when School was Recognized: July 07, 1969_ Number: R.O. No. 184 Year: 1969

III. ACTUAL DELIVERIES

Date of Time of Gender Supervised by:

No. Case # Diagnosis Name of Mother Age Name of Hospital Type of Delivery Name and Signature of
Delivery Delivery of Baby Qualified CI

1 RHU4- Pregnancy Uterine Full Term, Cephalic in Felicia Gustor 33 years old 02-17-2009 11:54 PM Female Caypombo Birthing Station Normal Spontaneous Delivery Mary Ann C. Diculen MD, RN
332 Presentation, Gravida 2 Para 2

2 RHU4- Pregnancy Uterine Full Term, Cephalic in Glenda Torre 20 years old 10-23-2009 6:50 AM Male Caypombo Birthing Station Normal Spontaneous Delivery Mary Ann C. Diculen MD, RN
297 Presentation, Gravida 2 Para 2

3 RHU4- Pregnancy Uterine Full Term, Cephalic in Jenelyn Guinoo 33 years old 11-11-2009 10:25 PM Male Caypombo Birthing Station Normal Spontaneous Delivery Mary Ann C. Diculen MD, RN
308 Presentation, Gravida 1 Para 1
Pregnancy Uterine 38-39 weeks Age of
4 498383 Gestation, Cephalic in Presentation, Gravida 3 Czarina Oseron 23 years old 02-03-2010 4:38 AM Male Jose R. Reyes Memorial Medical Normal Spontaneous Delivery Violeta M. Dungca RN, MAN
Para 3 Center

536771 Pregnancy Uterine 40-41 weeks Age of Carmi Dimalig 37 years old 02-10-2010 3:59 AM Female Jose R. Reyes Memorial Medical Normal Spontaneous Delivery Violeta M. Dungca RN, MAN
5
Gestation, Cephalic in Presentation, Gravida 4 Center
Para 4

Concurred by: Concurred by: Supervised by: Supervised by:

HELEN G. GERONA RN MAN-c ELSIE I. SARABIA RN, MAN MARY ANN C. DICULEN MD, RN VIOLETA M. DUNGCA RN, MAN
Chief Nurse Chief Nurse Clinical Instructor Clinical Instructor
Caypombo Birthing Station Jose R. Reyes Memorial Medical Center Caypombo Birthing Station Jose R. Reyes Memorial Medical Center
Degree: BSN Date Signed: __________ Degree: BSN, MAN Date Signed: __________ Degree: MD, BSN Date Signed: __________ Degree: BSN, MAN Date Signed: __________
PRC No. 0195180 Valid Until 10-27-2011 PRC No. 0051967 Valid Until October 2012 PRC No. 372093 Valid Until 04-03-2010 PRC No. 178589 Valid Until 11-24-2010
PNA No. 018433 Valid Until Lifetime___ PNA No. 014415 Valid Until Lifetime PNA No. 006839 Valid Until 10-31-2010 PNA No. 18503 Valid Until Lifetime

Noted by: Approved by: Legend: Prepared by:

ESTER S. CLIMACO RN, MAN ROBERTO C. SOMBILLO RN, RM, MAN

Overall Clinical Coordinator Dean
Degree: BSN, MAN Degree: BSN, MIDWIFERY, MAN ________________________________
PRC No.: 042052 Valid Until: 10-16-2011 PRC No.: 0172832 Valid Until: 08-02-2010 SONNY MA. H. MORENTE
PNA No.: 4275 Valid Until: Lifetime ADPCN No.: 0779 Valid Until: 2010 (Student’s Signature over Printed Name)
PNA No.: 4275 Valid Until: Lifetime
 Arellano University
NAME OF STUDENT: MORENTE, SONNY MA. HIZOLA________________
College of Nursing First Course (if any): _______Not Applicable_______
Name of School: 2600 Legarda
Arellano University___________________________ __ St. Sampaloc, Manila
School Graduated:_________Not Applicable_______

Address of School: 2600 Legarda St. Sampaloc, Manila______________ Year Admission in the BSN Program:_______2005_____
Year Graduated from the BSN Program:____2010_____
Recognition and Accreditation Level: PACUCOA Level I Formal (September 16, 2006)__
Date when School was Recognized: July 07, 1969_ Number: R.O. No. 184 Year: 1969_

IV. DELIVERIES ASSISTED

No. Name of Date of Time of Gender Supervised by:
Case # Diagnosis Age Name of Hospital Type of Delivery Name and Signature of
Mother Delivery Delivery of Baby Qualified CI

1 536076 Pregnancy Uterine 41-42 Weeks Age of Gestation, Liezel Fortuna 30 years old February 9, 2010 12: 45 AM Female Jose R. Reyes Memorial Medical Normal Spontaneous Delivery Violeta M. Dungca RN, MAN
Cephalic in Presentation, Gravida 2 Para 2 Center

2 538389 Pregnancy Uterine 36 Weeks Age of Gestation, Cephalic Geraldine 36 years old February 11, 2010 2:04 AM Female Jose R. Reyes Memorial Medical Normal Spontaneous Delivery Violeta M. Dungca RN, MAN
in Presentation, Gravida 4 Para 3 Carillas Center

3 095200 Pregnancy Uterine 376/7 Weeks Age of Gestation Chasten Grace 22 years old February 17, 2010 6:35 PM Male Ospital ng Sampaloc Normal Spontaneous Delivery Joanne Marie S. Garcia RN,
Cephalic in Labor, Gravida 1 Para 0 Taruc MAN

4 480501 Pregnancy Uterine 401/7 Weeks Age of Gestation, Ma. Gesela 20 years old February 24, 2010 3:25 Pm Female Ospital ng Sampaloc Normal Spontaneous Delivery Joanne Marie S. Garcia RN,
Cephalic In Labor, Gravida 1 Para 0 Guarte MAN

5 500501 Pregnancy Uterine 37 5/7 Weeks Age of Gestation, Rhea Kunday 30 years old February 24, 2010 7:59 PM Female Ospital ng Sampaloc Normal Spontaneous Delivery Joanne Marie S. Garcia RN,
Cephalic in Labor, Gravida 1 Para 0 MAN

Concurred by: Concurred by: Supervised by: Supervised by:

ELSIE I. SARABIA RN, MAN GRACE D. ZALDUA RN, MAN VIOLETA M. DUNGCA RN, MAN JOANNE MARIE S. GARCIA RN, MAN
Chief Nurse OIC, Chief Nurse Clinical Instructor Clinical Instructor
Jose R. Reyes Memorial Medical Center Ospital ng Sampaloc Jose R. Reyes Memorial Medical Center Ospital ng Sampaloc
Degree: BSN, MAN Date Signed: __________ Degree: BSN, MAN Date Signed:_________ Degree: BSN, MAN Date Signed: __________ Degree: BSN, MAN Date Signed:____________
PRC No. 0051967 Valid Until October 2012 PRC No. 0142514 Valid Until 05-26-2012 PRC No. 178589 Valid Until November 24, 2010 PRC No. 0220441 Valid Until June, 2012_____
PNA No. 014415 Valid Until Lifetime____ PNA No. 015062 Valid Until Lifetime___ PNA No. 18503 Valid Until Lifetime_____ PNA No. 006838 Valid Until 10-31-2010_____
Noted by: Approved by: Legend: Prepared by:

ESTER S. CLIMACO RN, MAN ROBERTO C. SOMBILLO RN, RM, MAN

Overall Clinical Coordinator Dean
Degree: BSN, MAN Degree: BSN, MIDWIFERY, MAN ________________________________
PRC No.: 042052 Valid Until: 10-16-2011 PRC No.: 0172832 Valid Until: 08-02-2010 SONNY MA. H. MORENTE
PNA No.: 4275 Valid Until: Lifetime ADPCN No.: 0779 Valid Until: 2010 (Student’s Signature over Printed Name)
PNA No.: 4275 Valid Until: Lifetime
 Arellano University
College of Nursing
NAME OF STUDENT: MORENTE, SONNY MA. HIZOLA _____ _____ First Course (if any): Not Applicable___ ____ ___
2600 Legarda St. Sampaloc, Manila
Name of School: Arellano University_____________________ ___ School Graduated: Not Applicable____ ___ __
Address of School: 2600 Legarda St. Sampaloc, Manila___ _______ _ Year Admission in the BSN Program: 2005___ _ ___
Recognition and Accreditation Level: PACUCOA Level I Formal (September 16, 2006)__ Year Graduated from the BSN Program: 2010______ __
Date when School was Recognized: July 07, 1969 Number: R.O. No. 184 Year: 1969__
30

V. CORD DRESSING
Gender of Supervised by:
No. Case # Date Performed Name of Baby Name of Mother Age Name of Hospital
Baby Name and Signature of Qualified CI

1
RHU4- 298 10-24-2009 Baby Girl Rosalejos Male Maristela Rosalejos 25 years old Caypombo Birthing Station Mary Ann C. Diculen MD, RN
2 RHU4- 307 11-09-2009 Baby Boy Pinca Male Soledad Pinca 35 years old Caypombo Birthing Station Mary Ann C. Diculen MD, RN

3
RHU4- 331 12-17-2009 Baby Girl Alvar Female Cherry Ann Alvar 26 years old Caypombo Birthing Station Mary Ann C. Diculen MD, RN

4 536032 02-09-2010 Baby Boy Naadat Male Amy Naadat 39 years old Jose R. Reyes Memorial Medical Center Violeta M. Dungca RN, MAN

5 540826 02-10-2010 Baby Girl Palomar Female Angelita Palomar 41 years old Jose R. Reyes Memorial Medical Center Violeta M. Dungca RN, MAN

Concurred by: Concurred by: Supervised by: Supervised by:

HELEN G. GERONA RN MAN-c ELSIE I. SARABIA RN, MAN MARY ANN C. DICULEN MD, RN VIOLETA M. DUNGCA RN, MAN
Chief Nurse Chief Nurse Clinical Instructor Clinical Instructor
Caypombo Birthing Station Jose R. Reyes Memorial Medical Center Caypombo Birthing Station Jose R. Reyes Memorial Medical Center
Degree: BSN Date Signed: __________ Degree: BSN, MAN Date Signed: __________ Degree: MD, BSN Date Signed: __________ Degree: BSN, MAN Date Signed: __________
PRC No. 0195180 Valid Until October 27, 2011 PRC No. 0051967 Valid Until October 2012 PRC No. 372093 Valid Until April 3, 2010 PRC No. 178589 Valid Until November 24, 2010
PNA No. 018433 Valid Until Lifetime________ PNA No. 014415 Valid Until Lifetime_____ PNA No. 006839 Valid Until October 31, 2010 PNA No. 18503 Valid Until Lifetime

Noted by: Approved by: Legend: Prepared by:

ESTER S. CLIMACO RN, MAN ROBERTO C. SOMBILLO RN, RM, MAN

Overall Clinical Coordinator Dean ________________________________
Degree: BSN, MAN Degree: BSN, MIDWIFERY, MAN SONNY MA. H. MORENTE
PRC No.: 042052 Valid Until: 10-16-2011 PRC No.: 0172832 Valid Until: 08-02-2010 (Student’s Signature over Printed Name)
PNA No.: 4275 Valid Until: Lifetime ADPCN No.: 0779 Valid Until: 2010
PNA No.: 4275 Valid Until: Lifetime