.

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): School Graduated: Year of Admission in the BSN Program: Year Graduated in BSN Program:
Type of Anesthesi a
Local Anesthesia Spinal Anesthesia

Not Applicable Not Applicable June 2007 October 2010

I.
No .

MAJOR OPERATION
Operation Performed Name of Surgeon
Name of Hospital

Date of Operation

Cas e No.
3852 726740

Name of Patient

Diagnosis

1 2

January 29, 2010 May 7, 2010

Camagay, Ulysses Macalaguing, Rosalyn

Cataract, Senile, Mature Pregnancy Uterine, 37 weeks age of gestation, not in labor, oligohydramnios, persistent variable deceleration, Gravida 2, Para 1 (1001) Pregnancy uterine full term complete breech presentation in labor, Gravida 1, teenage pregnancy Cystolithiasis, solitary

Phacoemulsification with intraocular lens, left eye Primary Low Segment Transverse Caesarean Section Primary Low Segment Transverse Caesarean Section

Dr. Rustan Hautea Dr. Erwin Jessie Taghoy

Cagayan de Oro Medical Center Northern Mindanao Medical Center Northern Mindanao Medical Center

Spinal Anesthesia

Dr. Erwin Jessie Taghoy

Jonah Nearia, R.N.

May 28, 2010

722808

Clemencio, Jenie

August 3, 2010

017302

Dimagnaog, Roger

Cystourethroscopy, intracorporeal lithotripsy, cystolitholapaxy Open treatment of Bimalleolar fracture with internal fixation Application of short leg cast

General Anesthesia Spinal Anesthesia

Dr. Ferdinand Miranda

Capitol University Medical City

Raquel Obenza, R.N.

August 10, 2010

015532

Pabua, Maricyth

Bimalleolar Fracture, Right

Dr. Leonard Khu

Capitol University Medical City

Cyrus Galleros, R.N.

Prepared by: _Julius Caezar Remerata Lucot_ Signature over printed name of Applicant

Supervised by: Ms. Jessele B. Janioso, R.N., M.N. Signature over printed name of Clinical Instructor Capitol University, College of Nursing Date Signed: ________________ Degree: Master in Nursing PRC No.: 0356131 Valid Until: January 27, 2013 PNA No.: 045620

Concurred by: Dorothea N. Roque, R.N.,Ed.D. Signature over printed name of Chief Nurse Northern Mindanao Medical Center Date Signed: ___________________ Degree: Doctor of Education PRC No.: 0041397 Valid Until: February 6, 2013 PNA No.: 045650 Valid Until: October 31, 2011

Concurred by: Annie P. Jacalan, R.N., Ph.D. Signature over printed name of Nursing Service Director Capitol University Medical City Date Signed: ___________________ Degree: Ph.D. PRC No.: 0062289 Valid Until: July 25, 2011

Noted by:

Approved by:

Mrs. Jenny R. Balo, R.N.,Mrs. Fidela B. Ansale, R.N., M.A.N. M.A.N. Signature over printed name of Signature over printed name of the Clinical Coordinator Dean Capitol University, College of Capitol University, College of Nursing Nursing Date Signed: Date Signed: ___________________ Degree: Master of Arts in Degree: Master of Arts in Nursing Nursing PRC No.: 0257481 0085045 Valid Until: June 20, 2012 PRC No.: Valid Until: February 7, 2013 PNA No.: 045618 PNA 045624 Valid Until: October 31, 2011 No.: Valid Until: October 31, 2011

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the BSN Program: June 2007 Year Graduated in BSN Program: October 2010

II.
No .
1

MINOR OPERATION
Operation Performed Type of Anesthesi a
Local Anesthesia

Date of Operation
July 10, 2009

Case No.
629072

Name of Patient
Santorias, Gemma

Diagnosis

Name of Surgeon
Dr. Pauline Tehaiya Cutab

Name of Hospital
Northern Mindanao Medical Center Northern Mindanao Medical Center Northern Mindanao Medical Center

Name and Signature of O.R Scrub Nurse

Incomplete abortion spontaneous 13 weeks age of gestation Lacerated wound 4 centimeter fourth digit distal third, right Infected sebaceous cyst right Traumatic amputation third digit distal phalanx left

Evacuation and Curettage

November 20, 2009

640513

Casas, Florentino

Suturing of lacerated wound 4 centimeter fourth digit distal third, right Incision and drainage

Local anesthesia

Dr. Mauro Bravo III

Richard Lai, R.N.

May 04, 2010

075794

Barcelona, Marcial

Local anesthesia

Dr. Ronnie Repollo

Geovanni Capistrano R.N.

Maja, Mamiel 4 June 22, 2010 496236

Completion of amputation third digit phalanx left

Local anesthesia

Dr. Alfred Rubio

Northern Mindanao Medical Center

Giovannie Abuso, R.N.

Noted by:
5 June 29, 2010 496716 Muyco, Junnald Skin tag right face Excision Local anesthesia Dr. Broxil Macabinlar Northern Mindanao Giovanni Capistrano, R.N. Medical Center Mrs. Jenny R. Balo, R.N., M.A.N. Signature over printed name of Clinical Coordinator Capitol University, College of Nursing Date Signed: Degree: Master of Arts in Nursing PRC No.: 0257481 Valid Until: June 20, 2012 PNA No.: 045618 Valid Until: October 31, 2011

Concurred by:
Prepared by: _Julius Caezar Remerata Lucot_ Signature over printed name of Applicant

Approved by: Mrs. Fidela B. Ansale, R.N., M.A.N. Signature over printed name of the Dean Capitol University, College of Nursing Date Signed: ___________________ Degree: Master of Arts in Nursing

Supervised by: Mrs. Marithel R. Moreno, R.N., M.N. Signature over printed name of Clinical Instructor Capitol University, College of Nursing Date Signed: ________________ Degree: Master in Nursing

DOROTHEA N. ROQUE, R.N.,Ed.D. Signature over printed name of Chief Nurse Northern Mindanao Medical Center Date Signed: ___________________ Degree: Doctor of Education

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the BSN Program: June 2007 Year Graduated in BSN Program: October 2010

III.
No. Case No Diagnosis Name of Mother Age Date of Delivery

DELIVERIES HANDLED
Time of Deliv ery
7:15 am

Gende r of Baby
Male

Name of Hospital

Type of Delivery

Supervised by Name and Signature of Clinical Instructor

438706

Delivery Term Spontaneous

Ann Dologuin

18 years old 26 years old

July 10, 2009

Northern Mindanao Medical Center Northern Mindanao Medical Center

Normal Vaginal Delivery Normal Vaginal Delivery Normal Vaginal Delivery Normal Vaginal Delivery

Spontaneous

629304

Delivery Term Spontaneous

Socralyn Madjos

July 10, 2009

2:30 pm

Female

Spontaneous

Bergris Puerto, R.N., M.N.

4876

Delivery Term Spontaneous

Joyce Lagamayo

33 years old

July 10, 2009

12:35 am

Male

De Oro Mothers Joy Birthing Homes Incorporated De Oro Mothers Joy Birthing Homes Incorporated

Spontaneous

Yvette Batar, R.N., M.A.N.

4894

Delivery Term Spontaneous

Aiza Mae Perez

25 years old

August 1, 2009

12:05 am

Female

Spontaneous

Yvette Batar, R.N., M.A.N.

Prepared by:
Julius Caezar Remerata Lucot Signature over printed name of Applicant

Concurred by: Mr. Gerardo Baconguis Signature over printed name of Supervisor Bugo Health Center and Lying-in Clinic Date Signed: ___________________ Degree: Nursing PRC No.: 0222188 Valid Until: October 27, 2011

Concurred by: Dorothea N. Roque, R.N.,Ed.D. Signature over printed name of Chief Nurse Northern Mindanao Medical Center Date Signed: ___________________ Degree: Doctor of Education PRC No.: 0041397 Valid Until: February 6, 2013 PNA No.: 045650 Valid Until: October 31, 2011

Noted by: Mrs. Jenny R. Balo, R.N., M.A.N. Signature over printed name of Clinical Coordinator Capitol University, College of Nursing Date Signed: Degree: Master of Arts in Nursing PRC No.: 0257481

Approved by: Mrs. Fidela B. Ansale, R.N., M.A.N. Signature over printed name of the Dean Capitol University, College of Nursing Date Signed: ___________________ Degree: Master of Arts in Nursing PRC No.: 0085045 Valid Until: February 7, 2013

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the BSN Program: June 2007 Year Graduated in BSN Program: October 2010

IV.
No. Case No Diagnosis Name of Mother Age Date of Delivery

DELIVERIES ASSISTED
Time of Deliv ery
12:43 pm 10:05 am 2:03 pm

Gende r of Baby
Male Male

Name of Hospital

Type of Delivery

Supervised by Name and Signature of Clinical Instructor

1 2

434494 627706

Delivery Term Spontaneous Delivery Term Spontaneous

Jesil Reyes Ellen Opena

22 years old 24 years old 29 years old 33 years old 20 years

July 3, 2009 July 10, 2009

Northern Mindanao Medical Center Northern Mindanao Medical Center De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy

Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous Vaginal Delivery Normal Spontaneous

4674

Delivery Term Spontaneous

Aileen Ocasio

July 16, 2009

Female

Bergris Puerto, R.N., M.N.

4874

Delivery Term Spontaneous

Ruth Fernandez

July 7, 2010

12:14 am 9:51 pm

Male

Yvette Batar, R.N., M.A.N.

4892

Delivery Term Spontaneous

Marivic Velozo

July 26, 2010

Female

. Yvette Batar, R.N., M.A.N.

Prepared by:
Julius Caezaar Remerata Lucot Signature over printed name of

Concurred by: Mrs. Imelda B. Torculas R.M. Signature over printed name of Supervisor De Oro Mothers Joy Birthing Home Inc. Date Signed: ___________________ Degree: Midwifery PRC No: 0126533 Valid Until: May 28, 2013

Concurred by:

Concurred by:

Noted by: Mrs. Jenny R. Balo, R.N., M.A.N. Signature over printed name of Clinical Coordinator Capitol University, College of Nursing Date Signed: Degree: Master of Arts in Nursing PRC No: 0257481 Valid Until: June 20, 2012 PNA No.: 045618

Approved by: Mrs. Fidela B. Ansale, R.N., M.A.N. Signature over printed name of the Dean Capitol University, College of Nursing Date Signed: ___________________ Degree: Master of Arts in Nursing PRC No: 0085045 Valid Until: February 7, 2013

Mrs. Rose P. Salta M.D., R.N.Mrs. Dorothea N. Roque, Signature over printed name of R.N., Ed.D. Signature over printed name of Supervisor Marys Child Lying-in Clinic Chief Nurse Northern Mindanao Medical Date Signed: ___________________ Degree: Doctor of Medicine Center Date Signed: PRC No: 45021 ___________________ Valid Until: May 5, 2013 Degree: Doctor of Education PRC No.: 0041397

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the BSN Program: June 2007 Year Graduated in BSN Program: October 2010

V. CORD DRESSING
No .
1. 2. 3. 4. 5.

Case No.

Date Performed
July 2, 2009 June 4, 2010 July 8, 2010 December 2010 July 30, 2010 19,

Name of Baby

Gender of Baby
Male Male Female Male Male

Name of Mother
Sohaida Minalag Tomaws Marjorie Blando Emmalyn Razo Ma. Antoniet Velozo Mariel Sebastian

Age

Name of Hospital

Supervised by Name and Signature of Clinical Instructor

4603 4855 4875 4987 4893

Baby Tomawis Baby Michael Baby Natalie Baby Mark Baby Mark Lawrence

21 years old 33 years old 29 years old 25 years old 30 years old

De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy Birthing Home Incorporated De Oro Mothers Joy Birthing Home Incorporated

Yvette Batar, R.N., M.A.N. Yvette Batar, R.N., M.A.N. Yvette Batar, R.N., M.A.N. Yvette Batar, R.N., M.A.N.

Concurred by:

Concurred by: Mrs. Imelda B. Torculas R.M. Signature over printed name of Supervisor De Oro Mothers Joy Birthing Home Inc. Date Signed: ___________________ Degree: Midwifery PRC No: 0126533 Valid Until: May 28, 2013

Noted by: Mrs. Jenny R. Balo, R.N., M.A.N. Signature over printed name of Clinical Coordinator Capitol University, College of Nursing Date Signed: Degree: Master of Arts in Nursing PRC No: 0257481 Valid Until: June 20, 2012 PNA No.: 045618 Valid Until: October 31, 2011

Approved by: Mrs. Fidela B. Ansale, R.N., M.A.N. Signature over printed name of the Dean Capitol University, College of Nursing Date Signed: ___________________ Degree: Master of Arts in Nursing PRC No: 0085045 Valid Until: February 7, 2013 PNA No.: 045624 Valid Until: October 31, 2011

Prepared by:
Julius Caezar Remerata Lucot
Signature over printed name Mr. Gerardo Baconguis Signature over printed name of Supervisor Bugo Health Center and Lying-in Clinic Date Signed: ___________________ Degree: Nursing PRC No.: 0222188 Valid Until: October 27, 2010

Capitol University
College of Nursing
Cagayan de Oro City

Name of Student: Julius Caezar Remerata Lucot Name and Address of School: Capitol University, Corrales Ext. & Osmea Ext. Streets, Cagayan de Oro City Recognition and Accreditation Level: CHED 070: PACUCOA Level 2 Date when school was recognized: June 14, 1982 Manila

First Course (if any): Not Applicable School Graduated: Not Applicable Year of Admission in the BSN Program: June 2007 Year Graduated in BSN Program: October 2010

VI. CIRCULATING
No .
1 2 3 4 5

Date of Operation
January 29, 2010 May 7, 2010 May 8, 2010 June 29, 2010 July 20, 2010

Case No.
3851 474070 492756 456654 003595

Name of Patient
Escobido, Silvino Escol, Vivencio Ranile, Carmen Montecillo, Manuel Dominguez, Vivian

Diagnosis

Operation Performed
Phacoemulsification with intraocular lens, left eye Subtotal Thyroidectomy, total lobectomy right isthmusectomy Pelvic laparotomy right salphingectomy Excision Total thyroid lobectomy right with isthmusectomy extended

Type of Anesthesia
Local Anesthesia General Anesthesia Spinal anesthesia Local Anesthesia General Anesthesia

Name of Surgeon
Dr. Rustan Hautea Dr. Marc Angelo Llosa Dr. Pauline Cutab Tehaiya

Name of Hospital

Cataract, Senile, Mature Goiter, colloid, non-toxic, status post fine needle aspiration biopsy Ectopic pregnancy probable ruptured, Gravida 2, Para 1 (1001) Skin tag right zygomatic area Nodular non-toxic goiter probably malignant

Cagayan Center Northern Center Northern Center Northern Center Capitol Center

de

Oro

Medical Medical Medical Medical Medical

Mindanao Mindanao Mindanao University

Dr. Broxil Macabinlar Dr. Bernabe Mendoza

Supervised by:

Noted by: Mrs. Jenny R. Balo, R.N., M.A.N. Signature over printed name of Clinical Coordinator Capitol University, College of Nursing Date Signed: Degree: Master of Arts in Nursing PRC No: 0257481 Valid Until: June 20, 2012 PNA No.: 045618 Valid Until: October 31, 2011

Approved by: Mrs. Fidela B. Ansale, R.N., M.A.N. Signature over printed name of the Dean Capitol University, College of Nursing Date Signed: ___________________ Degree: Master of Arts in Nursing PRC No: 0085045 Valid Until: February 7, 2013 PNA No.: 045624 Valid Until: October 31, 2011

Prepared by:
Julius Caezar Remerata Lucot Signature over printed name of Applicant Mrs. Lourdes H. Picar, R.N., M.N. Signature over printed name of Clinical Instructor Capitol University, College of Nursing Date Signed: _______________ Degree: Master in Nursing PRC No.: 019393 Valid Until: December 8, 2011 PNA No.: 3967 Valid Until: Life member