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UNIVERSITY OF SOUTHERN PHILIPPINES ODC FORM

FOUNDATION CORD CARE FORM


College of Nursing
Salinas Drive, Lahug, Cebu City
Telephone No.: 414-8773 local 112, Fax No.: 414-7772

IMMEDIATE NEW BORN CARE

Date Patients
performed INITIALS Only Immediate New Born Care Name of Hospital Clinical Instructor
Time Started Case Number Performed In (Name and Signature)

Dec. 21, 2016 B.B.G. Vicente Sotto Memorial Medical Mrs. Erlinda M. Guzman
12:24pm 77190 Normal Spontaneous Vaginal Delivery Center R.N.M.A.N

January 5, 2017 B.B.U Vicente Sotto Memorial Medical Mrs. Erlinda M. Guzman
12:15pm 79979 Normal Spontaneous Vaginal Delivery Center R.N.M.A.N

January 12, B.G.R. Vicente Sotto Memorial Medical Mrs. Erlinda M. Guzman
2017 81186 Normal Spontaneous Vaginal Delivery Center R.N.M.A.N
11:40am

Approved by:
Prepared by: Noted by:
AL GINO B. BORINAGA Merlyn A. Ouano R.N., M.N.
Mrs.Maria Virginia J. Tundag R.N.M.A.N. Dean
D.R. Coordinator PRC ID No. 0151708 Valid Until: Sept.15 2017
PRC ID No.0188642 Valid Until: Jan. 6 2018 Date:_____________ Time:___________
Date:_____________ Time:___________
Noted by: Noted by:

Ranilo A. Sabellano R.N., M.A.N. Ranilo A. Sabellano R.N., M.A.N.