Professional Documents
Culture Documents
PROCEDURE PERFORMED
(Indicate where performed eg. D.R., Nursery, NICU, or Home)
Nurse On Duty
(If Midwife on Duty, signature not required)
Signature
Signature
Noted by: MA. LIBERTY DG. PASCUAL, RN, MAN, Ph. D. Clinical Coordinator PRC ID. No. ___________ Valid Until _______________________ Date Documented is signed: ____________________________ Please specify Highest Nursing Degree Earned: MAN, Ph. D.
Approved by: TITA YAP- CRUZ, RN, MAN, Ed. D. Dean, School of Nursing PRC ID. No. _______________ Valid Until __________________ Date Documented is signed: _____________________________ Please specify Highest Nursing Degree Earned: MAN,
Ed. D.
As adopted by Far Eastern University- Dr. Nicanor Reyes Medical Foundation School of Nursing
Prepared by: ________________________________________ (Printed Name and Signature of Student) Date Performed and Time Started Patients Initial Only Case Number
(not applicable for Birthing Homes, Lying- In Clinics/ Homes)
PROCEDURE PERFORMED
(Indicate where performed eg. D.R., Nursery, NICU, or Home)
Nurse On Duty
(If Midwife on Duty, signature not required)
Signature
Signature
Noted by: MA. LIBERTY DG. PASCUAL, RN, MAN, Ph. D. Clinical Coordinator PRC ID. No. ___________ Valid Until _______________________ Date Documented is signed: ____________________________ Please specify Highest Nursing Degree Earned: MAN, Ph. D. Ed. D.
Approved by: TITA YAP- CRUZ, RN, MAN, Ed. D. Dean, School of Nursing PRC ID. No. _______________ Valid Until __________________ Date Documented is signed: _____________________________ Please specify Highest Nursing Degree Earned: MAN,
As adopted by Far Eastern University- Dr. Nicanor Reyes Medical Foundation School of Nursing
Regalado Avenue, near Dahlia Street, West Fairview, Quezon City, Philippines 1118 Tel. 427- 0213 Loc. 1147/ Website: www.feu-nrmf.edu.ph with Government Recognition No. 046 Series OF 2007, CHED (Per CEB Resolution Number 229- 2007) Prepared by: ________________________________________ (Printed Name and Signature of Student) Patients Initial Student Number: ___________________
Nurse On Duty
(If Midwife on Duty, signature not required)
Signature
Signature
Noted by: MA. LIBERTY DG. PASCUAL, RN, MAN, Ph. D. Clinical Coordinator PRC ID. No. ___________ Valid Until _______________________ Date Documented is signed: ____________________________ Please specify Highest Nursing Degree Earned: MAN, Ph. D. Ed. D.
Approved by: TITA YAP- CRUZ, RN, MAN, Ed. D. Dean, School of Nursing PRC ID. No. _______________ Valid Until __________________ Date Documented is signed: _____________________________ Please specify Highest Nursing Degree Earned: MAN,
As adopted by Far Eastern University- Dr. Nicanor Reyes Medical Foundation School of Nursing
Signature
Signature
Noted by: CONCEMARCIA V. BACON, RN, MAN Clinical Coordinator PRC ID. No. ___________ Valid Until _______________________ Date Documented is signed: ____________________________ Please specify Highest Nursing Degree Earned: MAN Ed. D.
Approved by: TITA YAP- CRUZ, RN, MAN, Ed. D. Dean, School of Nursing PRC ID. No. _______________ Valid Until __________________ Date Documented is signed: _____________________________ Please specify Highest Nursing Degree Earned: MAN,
As adopted by Far Eastern University- Dr. Nicanor Reyes Medical Foundation School of Nursing
Regalado Avenue, near Dahlia Street, West Fairview, Quezon City, Philippines 1118 Tel. 427- 0213 Loc. 1147/ Website: www.feu-nrmf.edu.ph with Government Recognition No. 046 Series OF 2007, CHED (Per CEB Resolution Number 229- 2007) Prepared by: ________________________________________ (Printed Name and Signature of Student) Date Performed and Time Started Patients Initial Only Case Number SURGICAL PROCEDURE PERFORMED Student Number: ___________________
Signature
Signature
Noted by:
Approved by:
Ed. D.
CONCEMARCIA V. BACON, RN, MAN Clinical Coordinator PRC ID. No. ___________ Valid Until _______________________ Date Documented is signed: ____________________________ Please specify Highest Nursing Degree Earned: MAN
TITA YAP- CRUZ, RN, MAN, Ed. D. Dean, School of Nursing PRC ID. No. _______________ Valid Until __________________ Date Documented is signed: _____________________________ Please specify Highest Nursing Degree Earned: MAN,