This document contains information about surgical operations and deliveries performed by a nursing student. It includes: 1. A list of 5 major surgical operations performed by the student from November 30 to December 7, 2010, including patient details, surgery performed, anesthesia used, surgeon, and hospital. 2. Sections for minor operations, actual deliveries, and deliveries assisted by the student from December to February 2010, including patient details, delivery details, and hospital. 3. Approval signatures from supervising nurses and the dean of the nursing school, as well as their professional details.

1. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: SERRAON, GREMELSON F. First Course (if any):
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated:
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2012
Date when school was recognized: October 24, 1996
I. MAJOR OPERATION
No. Date of Operation Case No. Name of Patient Diagnosis
Operation
Performed
Type of Anesthesia Name of Surgeon Name of Hospital
Supervised by
Qualified Clinical Instructor
1. Nov. 30, 2010 105439 Guevarra, Shiela Ovarian New Growth Left Salphingo Oophorectomy Spinal Dr. Ma. Lourdes Alonzo
Gat Andres Bonifacio
Memorial Medical Center
Antonio Valera III, R.N., M.A.N.
2. Dec. 1, 2010 105487 Balanguit, Alvin Acute Abdominal RUQ
Exploratory, Laparotomy, Repair
of Right Common Iliac Vein
General
Endotracheal
Anesthesia
Dr. Eleanor Cruz
Gat Andres Bonifacio
Memorial Medical Center
Antonio Valera III, R.N., M.A.N.
3. Dec. 6, 2010 105623 Gutierrez, Susan Nephrolithiasis
Pyelolithotomy
Right Kidney
General
Endotracheal
Anesthesia
Dr. Dennis Lusaya
Gat Andres Bonifacio
Memorial Medical Center
Antonio Valera III, R.N., M.A.N.
4. Dec. 6, 2010 105651 Zarraga, Angeline Ovarian Left Bilateral
Exlaporatory Oophorectomy
Adhesiolizis, Appendectomy
Spinal
Dr. Ma. Cecilia
Tolentino
Gat Andres Bonifacio
Memorial Medical Center
Antonio Valera III, R.N., M.A.N.
5. Dec. 7, 2010 105636 Andales, Rally Escalar
Dysfunctional Uterine bleeding,
Embedded IUD
Total Abdominal Hysterectomy Spinal Dr. Ma. Lourdes Alonzo
Gat Andres Bonifacio
Memorial Medical Center
Antonio Valera III, R.N., M.A.N.
Prepared by:
SERRAON, GREMELSON F.
Signature over printed name
Concurred by: Concurred by: Concurred by: Approved by:
LUDIVINA V. LINEZO, R.N., M.A.N. ASUNCION C. BALISADO, R.N., M.A.N. MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed name of Chief Nurse GABMMC Signature over printed name of Chief Nurse OMMC Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed: Date Signed: Date Signed:
Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N.
a). PRC No: 104356 a). PRC No: 0116547 a). PRC No: 0039563 a). PRC No: 087415
Valid until: January 28, 2014 Valid until: August 15, 2012 Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 0242080 b). PNA No: 14782 b). PNA No: 18153 b). PNA No: 5451
Valid until: December 2011 Valid until: Lifetime Member Valid until: Lifetime Member Valid until: Lifetime Member
c) ANSAP No: 006222 c). ANSAP No: 0044243 c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: Lifetime Member Valid until: December 10, 2011 Valid until: Lifetime Member Valid until: December 2014

2. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: Resteta G. Tjong First Course (if any): Bachelor of Science in Commerce Major in Marketing
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated: San Sebastian College Recoletos, Manila
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2011
Date when school was recognized: October 24, 1996
II. MINOR OPERATION
No. Date of Operation Case No. Name of Patient Diagnosis
Operation
Performed
Type of
Anesthesia
Name of Surgeon Name of Hospital
Supervised by
Qualified Clinical Instructor
1.
Local
Anesthesia
Dr. Juan Lim
Gat Andres Bonifacio
Memorial Medical
Center
Antonio Valera III, R.N., M.A.N.
2.
Local
Anesthesia
Mark Dennis Lim, M.D.
Mandaluyong
City Medical Center
Myrisia C Jocson, R.N., M.A.N.
3.
Local
Anesthesia
Mark Dennis Lim, M.D.
Mandaluyong
City Medical Center
Myrisia C Jocson, R.N., M.A.N.
4.
Local
Anesthesia
Alexander Vuelta,
M.D.
Mandaluyong
City Medical Center
Myrisia C Jocson, R.N., M.A.N.
5.
Local
Anesthesia
Santi Cruz, M.D.
Gat Andres Bonifacio
Memorial Medical
Center Ernie D. Carrido, R.N., M.A.N.
Prepared by:
Signature over printed name
Concurred by: Concurred by: Concurred by: Approved by:
TERESITA J. DIMAYACYAC, R.N., M.A.N. ASUNCION C. BALISADO, R.N., M.A.N. MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed name of Chief Nurse MCMC Signature over printed name of Chief Nurse OMMC Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed: Date Signed: Date Signed:
Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N.
a). PRC No: 0127552 a). PRC No: 0116547 a). PRC No: 0039563 a). PRC No: 087415
Valid until: October 2, 2013 Valid until: August 15, 2012 Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 17873 b). PNA No: 14782 b). PNA No: 18153 b). PNA No: 5451
Valid until: Lifetime Member Valid until: Lifetime Member Valid until: Lifetime Member Valid until: Lifetime Member
c) ANSAP No: 00615 c). ANSAP No: 0044243 c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: December 2011 Valid until: December 10, 2011 Valid until: Lifetime Member Valid until: December 2014

3. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: Resteta G. Tjong First Course (if any): Bachelor of Science in Commerce Major in Marketing
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated: San Sebastian College Recoletos, Manila
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2011
Date when school was recognized: October 24, 1996
III. ACTUAL DELIVERIES
No.
Case
No.
Diagnosis Name Mother Age Date of Delivery
Time of
Delivery
Gender of
Baby
Name of Hospital
Type of
Delivery
Supervised by
Qualified Clinical Instructor
1.
Gravity 1 Parity 1
Pregnancy Uterine 38 6/7 weeks
19 years
old
, 2010 12:03 PM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
2.
Gravity 4 Parity 4
Pregnancy Uterine 40 weeks
18 years
old
, 2010 12:00 NN Male
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
3.
Gravity 3 Parity 3
Pregnancy Uterine 38 weeks
18 years
old
, 2010 10:59 AM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
4.
Gravity 2 Parity 2
Pregnancy Uterine 38 1/7 weeks
41 years
old
, 2010 9:32 AM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
5.
Gravity 5 Parity 3
Pregnancy Uterine 38 weeks
30 years
old
, 2010 10:21 AM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
Prepared by:
Signature over printed name
Concurred by: Approved by:
MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed:
Degree: B.S.N., M.A.N Degree: B.S.N., M.A.N.
a). PRC No: 0039563 a). PRC No: 087415
Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 18153 b). PNA No: 5451
Valid until: Lifetime Member Valid until: Lifetime Member
c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: Lifetime Member Valid until: December 2014

4. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: Resteta G. Tjong First Course (if any): Bachelor of Science in Commerce Major in Marketing
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated: San Sebastian College Recoletos, Manila
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2011
Date when school was recognized: October 24, 1996
IV. DELIVERIES ASSISTED
No.
Case
No.
Diagnosis Name of Patient Age
Date of
Delivery
Time of
Delivery
Gender of
Baby
Name of Hospital
Type of
Delivery
Supervised by
Qualified Clinical Instructor
1.
Gravity 1 Parity 1
Pregnancy Uterine 38 weeks
30 years
old
, 2010 08:19 AM Male
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
2.
Gravity 1 Parity 1
Pregnancy Uterine 38 weeks
43 years
old
, 2010 08:01 AM Male
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
3.
Gravity 1 Parity 0
Pregnancy Uterine 38 weeks
18 years
old
, 2010 01:57 PM Male
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
4.
Gravity 1 Parity 0
Pregnancy Uterine 38 3/7 weeks
17 years
old
, 2010 06:08 AM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
5.
Gravity 2 Parity 1
Pregnancy Uterine 41 3/7 weeks
24 years
old
, 2010 11:17 AM Female
Ospital ng Maynila
Medical Center
Normal Spontaneous
Delivery
Ludivina Linezo, R.N., M.A.N.
Prepared by:
Signature over printed name
Concurred by: Concurred by: Approved by:
LUDIVINA V. LINEZO, R.N., M.A.N. MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed name of Chief Nurse GABMMC Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed: Date Signed:
Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N. Degree: B.S.N., M.A.N.
a). PRC No: 104356 a). PRC No: 0039563 a). PRC No: 087415
Valid until: January 28, 2014 Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 0242080 b). PNA No: 18153 b). PNA No: 5451
Valid until: December 2011 Valid until: Lifetime Member Valid until: Lifetime Member
c) ANSAP No: 006222 c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: Lifetime Member Valid until: Lifetime Member Valid until: December 2014

5. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: Resteta G. Tjong First Course (if any): Bachelor of Science in Commerce Major in Marketing
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated: San Sebastian College Recoletos, Manila
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2011
Date when school was recognized: October 24, 1996
V. CORD DRESSING
No.
Case
No.
Date Performed Name of Baby
Gender of
Baby
Name of Mother Age Name of Hospital
Supervised by
Qualified Clinical Instructor
1. July 15, 2010 BABY BOYMANLAPAS Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
2. July 15, 2010 BABY BOY RUBEN Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
3. July 16, 2010 BABY BOY SILVERIO Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
4. July 17, 2010 BABY GIRL PALEÑO Female years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
5. BABY BOY MENDOZA Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
Prepared by:
Signature over printed name
Concurred by: Approved by:
MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed:
Degree: B.S.N., M.A.N Degree: B.S.N., M.A.N.
a). PRC No: 0039563 a). PRC No: 087415
Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 18153 b). PNA No: 5451
Valid until: Lifetime Member Valid until: Lifetime Member
c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: Lifetime Member Valid until: December 2014

6. PHILIPPINE COLLEGE OF HEALTH SCIENCES, INC.
1813 C.M. RECTO AVE., MANILA
NAME OF STUDENT: Resteta G. Tjong First Course (if any): Bachelor of Science in Commerce Major in Marketing
Name and Address of school: Philippine College of Health Sciences, Inc. School graduated: San Sebastian College Recoletos, Manila
1813 C.M. Recto Avenue, Manila Year of admission in the BSN Program: 2009
Recognition and Accreditation Level: CHED Year graduated from the BSN Program: 2011
Date when school was recognized: October 24, 1996
V. CORD DRESSING
No.
Case
No.
Date Performed Name of Baby
Gender of
Baby
Name of Mother Age Name of Hospital
Supervised by
Qualified Clinical Instructor
1. July 15, 2010 BABY BOYMANLAPAS Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
2. July 15, 2010 BABY BOY RUBEN Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
3. July 16, 2010 BABY BOY SILVERIO Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
4. July 17, 2010 BABY GIRL PALEÑO Female years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
5. BABY BOY MENDOZA Male years old
Gat Andres Bonifacio
Memorial Medical Center
Ma. Teresa Yu, R.N., M.A.N.
Prepared by:
Signature over printed name
Concurred by: Approved by:
MARIE THERESE A. PACABIS, R.N., R.M., M.A.N. MARY JANE F. VILLANUEVA, R.N., M.A.N.
Signature over printed Name of Chief Nurse DJFMH Signature over printed Name of Dean
Date Signed: Date Signed:
Degree: B.S.N., M.A.N Degree: B.S.N., M.A.N.
a). PRC No: 0039563 a). PRC No: 087415
Valid until: October 12, 2012 Valid until: June 24, 2014
b). PNA No: 18153 b). PNA No: 5451
Valid until: Lifetime Member Valid until: Lifetime Member
c). ANSAP No.: 257 c). ADPCN No.: 001
Valid until: Lifetime Member Valid until: December 2014