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PRC form > 3 | Pregnancy | Nursing

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UNION CHRISTIAN COLLEGE San Fernando City, La Union Name of Student: Aguila, Jefferson Gomez Name and Address of School: UNION CHRISTIAN COLLEGE, Widdoes Street, San Fernando City, 2500, La Union Accreditation Level (if any): Level II Date School/Program was Recognized: June 14 Number: 198 First Course (if any): Not Applicable School graduated from: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007 Year Granted: 1999 Year: 197
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  UNION CHRISTIAN COLLEGE San Fernando City, La Union Name of Student: Aguila, Jefferson Gomez Name and Address of School: UNION CHRISTIAN COLLEGE , Widdoes Street, San Fernando City, 2500, La UnionAccreditation Level (if any): Level IIYear Granted: 1999Date School/Program was Recognized: June 14Number: 198Year: 1977First Course (if any): Not ApplicableSchool graduated from: Not ApplicableYear: Not Applicable Year of Admission in the Bachelor of Science in Nursing Program: 2003 Year Graduated (BSN Program): 2007 III. ACTUAL DELIVERIES No.Case No.DiagnosisName of MotherAgeDate of DeliveryTimeof DeliveryGenderof BabyName of HospitalType of DeliverySupervised by:Name & Signature of Qualified ClinicalInstructor 1HomeDeliveryPregnancy Uterine 40 weeks Ageof Gestation Cephalic in LaborGravida 1 Para 0 (G 1 P 0 )VirginiaPagaling Cu21February 27,20078:30AMFemaleTanqui HealthCenter City of San Fernando,La Union Normal Spontaneous Deliverywith Right Medio-LateralEpisiotomy (RMLE) Charmaine S. Abenes PRC #: 0266421PNA #:16309MAN units: 42 units 2HomeDeliveryPregnancy Uterine 39 weeks Ageof Gestation Cephalic in LaborGravida 4 Para 3 (G 4 P 3 )AsnairahMoctarMacapunag37January 6,200710:46AMMaleCabaroan HealthCenter City of San Fernando,La Union Normal Spontaneous Delivery Charmaine S. Abenes PRC #: 0266421PNA #:16309MAN units: 42 units 32006-0033127Pregnancy Uterine 40 weeks Ageof Gestation Cephalic in LaborGravida 2 Para 1 (G 2 P 1 )Marnelle Oca18December 23,20064:41AMMaleIlocos Training andRegional MedicalCenter (ITRMC)Normal Spontaneous Deliverywith Right Medio-LateralEpisiotomy (RMLE) Charmaine S. Abenes PRC #: 0266421PNA #:16309MAN units: 42 units 42006-0015243Pregnancy Uterine 39 ½ weeksAge of Gestation Cephalic in LaborGravida 1 Para 0 (G 1 P 0 )EdnalynCabanit Obaña27June 30, 200611:54PMMaleIlocos Training andRegional MedicalCenter (ITRMC)Normal Spontaneous Deliverywith Right Medio-LateralEpisiotomy (RMLE) Charmaine S. Abenes PRC #: 0266421PNA #:16309MAN units: 42 units 52006-0010595Pregnancy Uterine 40 weeks Ageof Gestation Cephalic in LaborGravida 1 Para o (G 1 P 0 )DinalynMadayagBaladad21May 4, 20067:50AMFemaleIlocos Training andRegional MedicalCenter (ITRMC)Normal Spontaneous Deliverywith Right Medio-LateralEpisiotomy (RMLE) Charmaine S. Abenes PRC #: 0266421PNA #:16309MAN units: 42 units Prepared by:  AGUILA, Jefferson G.  Name of StudentNoted by: Concurred by:Approved by: NORBERTO G. PREPOSE, JR., RN, MANFLORDELIZA R. BOBILES, RN, MANMARITES G. CALUGAN, RN, MANCRISTETA E. BAGTANG, RN, MPH, MAN Signature over printed Name of Clinical Coordinator Signature over printed name of Assistant Chief NurseSignature over printed name of Chief NurseSignature overprinted Name of DeanDate Signed: ________________________Date Signed: _____________________Date Signed: ________________________Date Signed: _____________________ Degree: BSN, RN, MANDegree: BSN, RN, MANDegree: BSN, RN, MANDegree: BSN,RN, MPH, MANa. PRC No.: 0209483a. PRC NO.: 0114833a. PRC NO.: 0166707a. PRC NO.:125448  Valid Until: April 2, 2009 Valid Until: March 27, 2008 Valid Until: May 16, 2009   Valid Until:October 24, 2009b. PNA No.: 16232b. PNA No.: 17945b. PNA No.: 14801b. PNA No.: 3051Valid Until: December 2007 Valid Until: Lifetime Member Valid Until: Lifetime Member Valid Until:Lifetime Memberc. ANSAP No: 00077c. ANSAP No: 01324c. ANSAP No.: 02252c. ADPCN No.:356Valid Until: Lifetime Member Valid Until: December 2007 Valid Until: December 2007 Valid Until:December 2007
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