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    DR Cases Form

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    Cyrus Garcia
    The document is a form from St. Joseph's College of Quezon City Institute of Nursing documenting immediate newborn cord care performed in the delivery room of Pasay City General Hospital. It records the initials of the patient, date, time and location that cord care was performed, and is signed by the clinical instructor and clinical coordinator verifying the documentation.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    DR Cases Form

    Uploaded by

    Cyrus Garcia
    27 views3 pages
    The document is a form from St. Joseph's College of Quezon City Institute of Nursing documenting immediate newborn cord care performed in the delivery room of Pasay City General Hospital. It records the initials of the patient, date, time and location that cord care was performed, and is signed by the clinical instructor and clinical coordinator verifying the documentation.

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    The document is a form from St. Joseph's College of Quezon City Institute of Nursing documenting immediate newborn cord care performed in the delivery room of Pasay City General Hospital. It records the initials of the patient, date, time and location that cord care was performed, and is signed by the clinical instructor and clinical coordinator verifying the documentation.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    27 views3 pages

    DR Cases Form

    Uploaded by

    Cyrus Garcia
    The document is a form from St. Joseph's College of Quezon City Institute of Nursing documenting immediate newborn cord care performed in the delivery room of Pasay City General Hospital. It records the initials of the patient, date, time and location that cord care was performed, and is signed by the clinical instructor and clinical coordinator verifying the documentation.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 3

    ST.

    JOSEPH'S COLLEGE OF QUEZON CITY


    Institute of Nursing
    295 E. Rodriquez Sr. Blvd, Quezon City
    Tel. No. 725-8386

    IMMEDIATE NEWBORN CORD CARE in Pasay City Ge

    Prepared by:

    Villamor, Karl Adrian


    Name and Signature of Student

    Patient's INITIAL Only


    Date Performed Immediate Newborn Cord Care PERFORMED
    and Case Number Indicate where
    (not applicable for perfomed e.g. D.R., Nusery,
    Time Started birthing/lying-in NICU or home
    clinics/homes
    4/12/2022 F.V.
    Delivery Room
    10:25 AM

    Delivery Room

    Delivery Room

    Noted by: MANUEL PRIMITIVO R. LIMON, RN, MAN, MSN Noted by:
    Clinical Coordinator
    PRC ID No. 405410 Valid Until: June 10, 2024 PRC ID No.
    Date Document is Signed:____________________ Time:________________ Date Document is Signed:__
    Highest Nursing Degree Earned: Master of Arts In Nursing Highest Nursing Degree Earn
    EGE OF QUEZON CITY
    of Nursing
    Sr. Blvd, Quezon City ODC FORM IC
    Cord Care Form
    725-8386

    ARE in Pasay City General Hospital

    D.R. Nurse on Duty


    (Name
    and Signature) SUPERVISED BY:
    (If Clinical Instructor
    midwife on duty, signature not (Name and Signature)
    required)

    Marjon L. Gonzales, RN

    Marjon L. Gonzales, RN

    Marjon L. Gonzales, RN

    AGNETIA C. NAVAL, SFIC


    Dean, Institute of Nursing
    34501 Valid Until: July 6, 2024
    e Document is Signed:____________________ Time:________________
    hest Nursing Degree Earned: PhD
    ST. JOSEPH'S COLLEGE OF QUEZON CITY
    Institute of Nursing
    295 E. Rodriquez Sr. Blvd, Quezon City D.R. FORM
    Actual Delivery Form
    Tel. No. 725-8386

    ACTUAL DELIVERY in Pasay City General Hospital

    Prepared by:

    Villamor, Karl Adrian


    Name and Signature of Student

    Patient's INITIAL Only


    D.R. Nurse on Duty
    Date Performed (Name and Signature) SUPERVISED BY:
    and Case Number PROCEDURE PERFORMED (If midwife on Clinical Instructor
    Time Started (not applicable for duty, signature not required) (Name and Signature)
    birthing/lying-in
    clinics/homes
    4/5/2022
    C.M. Normal Spontaneous Delivery
    7:25 AM Marjon L. Gonzales, RN

    Normal Spontaneous Delivery


    Marjon L. Gonzales, RN

    Normal Spontaneous Delivery


    Marjon L. Gonzales, RN

    Noted by: MANUEL PRIMITIVO R. LIMON, RN, MAN, MSN Noted by: AGNETIA C. NAVAL, SFIC
    Clinical Coordinator Dean, Institute of Nursing
    PRC ID No. 405410 Valid Until: June 10, 2024 PRC ID No. 34501 Valid Until: July 6, 2024
    Date Document is Signed:____________________ Time:________________ Date Document is Signed:____________________ Time:________________
    Highest Nursing Degree Earned: Master of Arts In Nursing Highest Nursing Degree Earned: PhD

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