Professional Documents
Culture Documents
SOUTHWESTERN UNIVERSITY
College of Nursing
Villa Aznar Urgello Street Cebu City
Phone no: 415-55-55 local 183, Telefax: 418-72-78, Email Address: swu.nursing@gmail.com
Prepared by:
Printed Name and Signature of Student Juan Santos dela Cruz
Noted by: RAMON PERLEY M. PANDAAN Approved by: LUCRIS A. TAN JR.
OR/DR Clinical Coordinator, PRC I.D. No. 0243199 Valid Until July 8, 2010 Dean, PRC I.D. No. 0285376 Valid Until April 9, 2012
Date document is signed:________Time____________ Date document is signed:________Time________
Please specify Highest Nursing Degree Earned: RN, MAN Specify Highest Nursing Degree Earned: RN, MD, MAN
(STRICTLY NO DESIGNATES)
ODC Form 2A
O.R. SCRUB FORM
Republic of the Philippines Major
Professional Regulation Commission
Board of Nursing
SOUTHWESTERN UNIVERSITY
College of Nursing
Villa Aznar Urgello Street Cebu City
Phone no: 415-55-55 local 183, Telefax: 418-72-78, Email Address: swu.nursing@gmail.com
Prepared by:
Printed Name and Signature of Student ______________________________________
Noted by: RAMON PERLEY M. PANDAAN Approved by: LUCRIS A. TAN JR.
OR/DR Clinical Coordinator, PRC I.D. No. 0243199 Valid Until July 8, 2010 Dean, PRC I.D. No. 0285376 Valid Until April 9, 2012
Date document is signed:________Time____________ Date document is signed:________Time________
Please specify Highest Nursing Degree Earned: RN, MAN Specify Highest Nursing Degree Earned: RN, MD, MAN
(STRICTLY NO DESIGNATES)
ODC Form 1B
Republic of the Philippines ASSISTED DELIVERY FORM
Professional Regulation Commission
Board of Nursing
SOUTHWESTERN UNIVERSITY
College of Nursing
Villa Aznar Urgello Street Cebu City
Phone no: 415-55-55 local 183, Telefax: 418-72-78, Email Address: swu.nursing@gmail.com
Prepared by:
Printed Name and Signature of Student ______________________________________
Noted by: RAMON PERLEY M. PANDAAN Approved by: LUCRIS A. TAN JR.
OR/DR Clinical Coordinator, PRC I.D. No. 0243199 Valid Until July 8, 2010 Dean, PRC I.D. No. 0285376 Valid Until April 9, 2012
Date document is signed:________Time____________ Date document is signed:________Time________
Please specify Highest Nursing Degree Earned: RN, MAN Specify Highest Nursing Degree Earned: RN, MD, MAN
(STRICTLY NO DESIGNATES)
Republic of the Philippines ODC Form 2B
Professional Regulation Commission O.R. SCRUB MINOR
Board of Nursing
SOUTHWESTERN UNIVERSITY
College of Nursing
Villa Aznar Urgello Street Cebu City
Phone no: 415-55-55 local 183, Telefax: 418-72-78, Email Address: swu.nursing@gmail.com
Prepared by:
Printed Name and Signature of Student ______________________________________
Noted by: RAMON PERLEY M. PANDAAN Approved by: LUCRIS A. TAN JR.
OR/DR Clinical Coordinator, PRC I.D. No. 0243199 Valid Until July 8, 2010 Dean, PRC I.D. No. 0285376 Valid Until April 9, 2012
Date document is signed:________Time____________ Date document is signed:________Time________
Please specify Highest Nursing Degree Earned: RN, MAN Specify Highest Nursing Degree Earned: RN, MD, MAN
(STRICTLY NO DESIGNATES)
ODC Form 1C
Republic of the Philippines IMMEDIATE NEWBORN CORD
Professional Regulation Commission CARE
Board of Nursing
SOUTHWESTERN UNIVERSITY
College of Nursing
Villa Aznar Urgello Street Cebu City
Phone no: 415-55-55 local 183, Telefax: 418-72-78, Email Address: swu.nursing@gmail.com
Prepared by:
Printed Name and Signature of Student ______________________________________
Noted by: RAMON PERLEY M. PANDAAN Approved by: LUCRIS A. TAN JR.
OR/DR Clinical Coordinator, PRC I.D. No. 0243199 Valid Until July 8, 2010 Dean, PRC I.D. No. 0285376 Valid Until April 9, 2012
Date document is signed:________Time____________ Date document is signed:________Time________
Please specify Highest Nursing Degree Earned: RN, MAN Specify Highest Nursing Degree Earned: RN, MD, MAN
(STRICTLY NO DESIGNATES)