REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATIONS COMMISSION

BOARD OF NURSING
Prepared by:
Name of Student: CASTILLO, FAME ROZZINI BAQUILO ________________________________________________________________________________________________________
Name and Address of School: Far Eastern University, Nicanor Reyes St. Sampaloc, Manila______________________________________________________________________________
Accreditation Level: Level II PAASCU Re-accredited ______________________________ Year Granted: March 21, 2001 ___________________________________________
Date School/ Program was recognized: __ April 10, 1958___ Number: 66_____________________________________ Year: 1958______________________________________
First Course (if any): None___ School Graduated from: Not Applicable___
Year of Admission in the Bachelor of Science in Nursing Program: 2007__
Year Graduated (BSN Program): 2011__
I. MAJOR OPERATIONS
Supervised by
Date of Case Name of Operation Type of Name of Name of O.R (Name & Signature
No. Diagnosis Name of Hospital
Operation No. Patient Performed Anesthesia Surgeon Scrub Nurse of Qualified Clinical
Instructor)
Gravida 2 Parity 1 Pregnancy
Uterine,37-38 Weeks Age of Low Transverse
June 23, Alma Maricar Rizal Provincial Julia Diosa Sta. Vicente Baylon III,
1 540165 Gestation CIBL to consider Caesarean Section Spinal
2010 Antonil Bautista, MD Hospital Maria, RN RN, MAN
PES previous Caesarean II
Section
Gravida 1 Parity 0 Pregnancy
Emergency Low
Uterine,36-37 Weeks Age of Maricel
September Monina Transverse Rizal Provincial Charito Delos Vicente Baylon
2 543434 Gestation, by Last menstrual Spinal Sucayan-Sta.
10, 2010 Estilo Caesarean Section Hospital Santos RN III,RN,MAN
period CIBL Elderly Ana, MD
I
Primigravida
Open fracture Complete
Debridement and Quezon City General
November Sonny comminuted Posterior- middle Alvin Amador, Amelita Miguel RN,
3 012049 application of Spinal Hospital- Medical Raul Ramos RN
11, 2010 Gozun third tibia left secondary to MD RM, MAN
external fixator Center
gunshot wound
Emergency
Right frontal cerebral Quezon City General
November Jonathan craniotomy Amelita Miguel
4 012050 contusion hematoma General Gil Gueco, MD Hospital- Medical Raul Ramos RN
11, 2010 Duante evaluation of RN,RM, MAN
secondary to fall Center
hematoma
Right Submandibular mass Excision of Quezon City General
November Andrew Ronaldo Reynaldo Basada Amelita Miguel
5 012059 to consider Pleomorphic Submandibular General Hospital- Medical
12, 2010 Genobaten Arzaga, MD RN RN,RM,MAN
adenoma gland Center
Noted by: Concurred by: Concurred by: Approved by:
Elizabeth F. Haciñas, RN, RM, MAN__________ ____________________________________ _____________________________________ Glenda S. Arquiza, RN, PhD_____________
Signature over printed name of Level Coordinator Signature over printed name of Chief Nurse Signature over printed Name of Signature over printed name of the Dean
Date Signed: _____________ Date Signed: ___________ Owner/Administrator Date Signed: __________
Degree: Master of Arts in Nursing____________ Degree: ____ Date Signed: ______ Degree: Doctor of Philosophy,____________
a.) PRC No.: 0101726__ _____________ a.) PRC No.: ___________ Degree:____ _ ______ Major in Educational Administration________
Valid Until: July 01, 2011 _____________ Valid Until: ___________ a.) PRC No.: ________________________ a.) PRC No.: 0043483 ___
b.) PNA No.: 4870 _____________ b.) PNA No.: ___________ Valid until: _ _____________________ Valid Until: ________________
Valid Until: Lifetime_____ _____________ Valid Until: ___________ b.) IMAP No.: __________________ b.) PNA No.: 19071 __________
c.) ANSAP No.: ________________________ Valid until: Valid Until: Lifetime __________
Valid Until: ___________________________ c.) ADPCN No.: __0786_________________
Valid Until: ___________________________
 REPUBLIC OF THE PHILIPPINES
PROFESSIONAL REGULATIONS COMMISSION
BOARD OF NURSING
Prepared by:
Name of Student: CASTILLO, FAME ROZZINI BAQUILO ________________________________________________________________________________________________________
Name and Address of School: Far Eastern University, Nicanor Reyes St. Sampaloc, Manila______________________________________________________________________________
Accreditation Level: Level II PAASCU Re-accredited ______________________________ Year Granted: March 21, 2001 ___________________________________________
Date School/ Program was recognized: __ April 10, 1958___ Number: 66_____________________________________ Year: 1958______________________________________
First Course (if any): None___ School Graduated from: Not Applicable___
Year of Admission in the Bachelor of Science in Nursing Program: 2007__
Year Graduated (BSN Program): 2011__
I. MINOR OPERATIONS
Supervised by
Date of Case Name of Operation Type of Name of Name of O.R (Name & Signature of
No. Diagnosis Name of Hospital
Operation No. Patient Performed Anesthesia Surgeon Scrub Nurse Qualified Clinical
Instructor)
June 20, Lacerated wound Jonathan Gabasa, Angono General Maria Theresa Lerma R. Berberabe
1 94572 Nica Entera Suturing Local
2010 occipital area MD Hospital Cerda, RN RN, MAN

June 23, Catalina Modesto Jose, Rizal Provincial Julia Diosa Vicente Baylon III, RN,
2 17371 Breast Mass Excision Biopsy Local
2010 Estrella MD Hospital Sta. Maria, RN MAN
Extra Capsular
Cataract
Extraction with Quezon City General
November Diosdado Senile Mature Dennis Jocelyn Amelita Miguel RN,RM,
3 012044 Posterior Local Hospital- Medical
10, 2010 Palma Cataract, Left Eye Punongbayan,MD Chavez, RN MAN
Chamber Intra Center
Ocular Lens, Left
eye
Quezon City General
November Calijan, Siliconoma, Silicon Removal of silicon Arsenio Pascual, Joey Ruazul, Amelita Miguel RN,RM,
4 012054 Local Hospital- Medical
12, 2010 Rosalinda Abscess implant MD RN MAN
Center
Quezon City General
November Rowena Acute Congestion Dennis Guingon, Jocelyn Amelita Miguel RN,RM,
5 012060 Appendectomy Spinal Hospital- Medical
13, 2010 Espaefo Appendicitis MD Chavez, RN MAN
Center
Noted by: Concurred by: Concurred by: Approved by:
Elizabeth F. Haciñas, RN, RM, MAN__________ ____________________________________ ____________________________ Glenda S. Arquiza, RN, PhD___________
Signature over printed name of Level Coordinator Signature over printed name of Chief Nurse Signature over printed Name of Signature over printed name of the Dean
Date Signed: _____________ Date Signed: ___________ Owner/Administrator Date Signed: ________
Degree: Master of Arts in Nursing____________ Degree: ____ Date Signed: _______ Degree: Doctor of Philosophy,__________
a.) PRC No.: 0101726__ _____________ a.) PRC No.: ___________ Degree:____ _ _______ Major in Educational Administration______
Valid Until: July 01, 2011 _____________ Valid Until: ___________ a.) PRC No.: _______________________ a.) PRC No.: 0043483 _
b.) PNA No.: 4870 _____________ b.) PNA No.: ___________ Valid until: _ ______________________ Valid Until: ______________
Valid Until: Lifetime_____ _____________ Valid Until: ___________ b.) IMAP No.: ___________________ b.) PNA No.: 19071 ________
c.) ANSAP No.: ________________________ Valid until: ______ Valid Until: Lifetime ________
Valid Until: ___________________________ c.) ADPCN No.: __0786_______________
Valid Until: _________________________
 REPUBLIC OF THE PHILIPPINES
PROFESSIONAL REGULATIONS COMMISSION
BOARD OF NURSING
Prepared by:
Name of Student: CASTILLO, FAME ROZZINI BAQUILO ________________________________________________________________________________________________________
Name and Address of School: Far Eastern University, Nicanor Reyes St. Sampaloc, Manila______________________________________________________________________________
Accreditation Level: Level II PAASCU Re-accredited ______________________________ Year Granted: March 21, 2001 ___________________________________________
Date School/ Program was recognized: __ April 10, 1958___ Number: 66_____________________________________ Year: 1958______________________________________
First Course (if any): None School Graduated from: Not Applicable
Year of Admission in the Bachelor of Science in Nursing Program: 2007
Year Graduated (BSN Program): 2011
III. ACTUAL DELIVERIES
Supervised by
Case Name of Date of Time of Gender of (Name & Signature of
No. Diagnosis Age Name of Hospital Type of Delivery
No. Mother Delivery Delivery Baby Qualified Clinical
Instructor)
Gravida1 Parity 0 Pregnancy Uterine, Zamora Medical Normal
I008- Louisa August 28,
1 39-40 Weeks Age of Gestation, Cephalic 24 12:09 PM Male Center- Lying in Spontaneous Nerissa Marcelino RN
1448 Santos 2009
in Labor Clinic Delivery
Gravida 3 Parity 2 Pregnancy Uterine, Normal
183- Carmi June 14, Angono General Lerma R. Berberabe, RN,
2 38-39 Weeks Age of Gestation, Cephalic 27 6:25 PM Female Spontaneous
65478 Cadungug 2010 Hospital MAN
in Labor Delivery
Gravida 2 Parity 1 Pregnancy Uterine, Normal
281-655 June 20, Angono General Lerma R. Berberabe, RN,
3 38-39 Weeks Age of Gestation, Cephalic Myrel Perez 21 5:26 PM Female Spontaneous
76 2010 Hospital MAN
in Labor Delivery
Gravida1 Parity 0 Pregnancy Uterine, 40 Normal
047- Cherry Beth Angono General Lerma R. Berberabe, RN,
4 Weeks Age of Gestation, Cephalic in 18 July 3,2010 7:42 PM Male Spontaneous
65782 Lopera Hospital MAN
Labor Delivery
Gravida 3 Parity 2 Pregnancy Uterine, Normal
227- Melissa November Angono General Lerma R. Berberabe, RN,
5 39-40 Weeks Age of Gestation, Cephalic 36 12:34 AM Male Spontaneous
68045 Sampaga 13, 2010 Hospital MAN
in Labor Delivery

Noted by: Concurred by: Concurred by: Approved by:

Elizabeth F. Haciñas, RN, RM, MAN____ ________________________________ _________________________________________ Glenda S. Arquiza, RN, PhD__________
Signature over printed name of Level Signature over printed Name of Owner/Administrator Signature over printed name of Owner/Administrator Signature over printed name of the Dean
Coordinator Date Signed: _________ Date Signed: _______________ Date Signed: _______
Date Signed: _______ Degree:____ _ _________ Degree: __________________________________ Degree: Doctor of Philosophy,_________
Degree: Master of Arts in Nursing______ a.) PRC No.: _____________________________ a.) PRC No.: _______________ _______________ Major in Educational Administration____
a.) PRC No.: 0101726__ _______ Valid until: _ ________________________ Valid Until: _______ _______________ a.) PRC No.: 0043483 _______
Valid Until: July 01, 2011 _______ b.) IMAP No.: _____________________ b.) PNA No.: ____ _______________ Valid Until: _____________
b.) PNA No.: 4870 _______ Valid until: _________ Valid Until: __________ _______________ b.) PNA No.: 19071 _______
Valid Until: Lifetime_____ _______ c.) ANSAP No.: ____________________________ Valid Until: Lifetime _______
Valid Until: ________________________________ c.) ADPCN No.: __0786_____________
Valid Until: _______________________
 REPUBLIC OF THE PHILIPPINES
PROFESSIONAL REGULATIONS COMMISSION
BOARD OF NURSING
Prepared by:
Name of Student: CASTILLO, FAME ROZZINI BAQUILO ________________________________________________________________________________________________________
Name and Address of School: Far Eastern University, Nicanor Reyes St. Sampaloc, Manila______________________________________________________________________________
Accreditation Level: Level II PAASCU Re-accredited ______________________________ Year Granted: March 21, 2001 ___________________________________________
Date School/ Program was recognized: __ April 10, 1958___ Number: 66_____________________________________ Year: 1958______________________________________
First Course (if any): None School Graduated from: Not Applicable
Year of Admission in the Bachelor of Science in Nursing Program: 2007
Year Graduated (BSN Program): 2011
IV. DELIVERIES ASSISTED
Supervised by
Case Name of Date of Time of Gender of Name of (Name & Signature of
No. Diagnosis Age Type of Delivery
No. Mother Delivery Delivery Baby Hospital Qualified Clinical
Instructor)
Angono Normal
195- Gravida 1 Parity 0 Pregnancy Uterine,39 Alona June 14, Lerma R. Berberabe, RN,
1 25 11:55 PM Male General Spontaneous
65490 Weeks Age of Gestation, Cephalic in Labor Jorquia 2010 MAN
Hospital Delivery
Angono Normal
200- Gravida 3 Parity 2 Pregnancy Uterine,39 Carmela June 15, Lerma R. Berberabe, RN,
2 28 3:20 AM Male General Spontaneous
65495 Weeks Age of Gestation, Cephalic in Labor Solano 2010 MAN
Hospital Delivery
Angono Normal
046- Gravida 1 Parity 0 Pregnancy Uterine,39 Mary Grace Lerma R. Berberabe, RN,
3 16 July 3, 2010 6:42 PM Female General Spontaneous
65781 Weeks Age of Gestation, Cephalic in Labor Ybanez MAN
Hospital Delivery
Angono Normal
468- Gravida 1 Parity 0 Pregnancy Uterine,37-38 Ces Janet July Lerma R. Berberabe, RN,
4 18 1:21 PM Male General Spontaneous
66203 Weeks Age of Gestation, Cephalic in Labor Diaz 31,2010 MAN
Hospital Delivery
Angono Normal
474- Gravida 2 Parity 1 Pregnancy Uterine,38-39 July Lerma R. Berberabe, RN,
5 Mariel Bacay 21 10:59 PM Female General Spontaneous
66209 Weeks Age of Gestation, Cephalic in Labor 31,2010 MAN
Hospital Delivery
Noted by: Concurred by: Approved by:
Elizabeth F. Haciñas, RN, RM, MAN____________________ _______________________________________________________________________________ Glenda S. Arquiza, RN, PhD_______________________________
Signature over printed name of Level Coordinator Signature over printed name of Owner/Administrator Signature over printed name of the Dean
Date Signed: _______________________ Date Signed: _____________________ Date Signed: ____________________________
Degree: Master of Arts in Nursing______________________ Degree: _____________________ Degree: Doctor of Philosophy, Major in Educational Administration_
a.) PRC No.: 0101726__ _______________________ a.) PRC No.: _____________________ a.) PRC No.: 0043483 ______________________
Valid Until: July 01, 2011 _______________________ Valid Until: _____________________ Valid Until: ___________________________________
b.) PNA No.: 4870 _______________________ b.) PNA No.: _____________________ b.) PNA No.: 19071 ____________________________
Valid Until: Lifetime_____ _______________________ Valid Until: _____________________ Valid Until: Lifetime ____________________________
c.) ANSAP No.: __________________________________ c.) ADPCN No.: __0786___________________________________
Valid Until: ______________________________________ Valid Until: _____________________________________________
 REPUBLIC OF THE PHILIPPINES
PROFESSIONAL REGULATIONS COMMISSION
BOARD OF NURSING
Prepared by:
Name of Student: CASTILLO, FAME ROZZINI BAQUILO ________________________________________________________________________________________________________
Name and Address of School: Far Eastern University, Nicanor Reyes St. Sampaloc, Manila______________________________________________________________________________
Accreditation Level: Level II PAASCU Re-accredited ______________________________ Year Granted: March 21, 2001 ___________________________________________
Date School/ Program was recognized: __ April 10, 1958___ Number: 66_____________________________________ Year: 1958______________________________________
First Course (if any): None School Graduated from: Not Applicable
Year of Admission in the Bachelor of Science in Nursing Program: 2007
Year Graduated (BSN Program): 2011
V. CORD DRESSING
Supervised by
(Name & Signature of
No. Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital
Qualified
Clinical Instructor)
Rugay Maternity and
1 05-6140 May 13, 2010 Baby Girl Guizano Female Rochelle Guizano 31 Rachelle S. Garcia, RN, MAN
General Hospital
198- Angono General
2 June 15, 2010 Baby Boy Resurrecion Male Caroline Resurrecion 34 Lerma R. Berberabe, RN, MAN
65493 Hospital
282- Angono General
3 June 20, 2010 Baby Boy Ruizol Male Flordelina Ruizol 29 Lerma R. Berberabe, RN, MAN
65577 Hospital
469- Angono General
4 July 31, 2010 Baby Boy Gazzingan Male Aryet Gazzingan 22 Lerma R. Berberabe, RN, MAN
66204 Hospital
230- Angono General
5 November 13, 2010 Baby Boy Mesarcia Male Rosalyn Mesarcia 26 Lerma R. Berberabe, RN, MAN
68048 Hospital
Noted by: Concurred by: Concurred by: Approved by:

Elizabeth F. Haciñas, RN, RM, MAN____ ____________________________________ _________________________________________ Glenda S. Arquiza, RN, PhD__________
Signature over printed name of Level Signature over printed Name of Owner/Administrator Signature over printed name of Owner/Administrator Signature over printed name of the Dean
Coordinator Date Signed: __________ Date Signed: _______________ Date Signed: _______
Date Signed: _______ Degree:____ _ __________ Degree: __________________________________ Degree: Doctor of Philosophy,_________
Degree: Master of Arts in Nursing______ a.) PRC No.: ___________ a.) PRC No.: _______________ _______________ Major in Educational Administration____
a.) PRC No.: 0101726__ _______ Valid until: _ __________________________ Valid Until: _______ _______________ a.) PRC No.: 0043483 _______
Valid Until: July 01, 2011 _______ b.) IMAP No.: ______________________ b.) PNA No.: ____ _______________ Valid Until: _____________
b.) PNA No.: 4870 _______ Valid until: _________ Valid Until: __________ _______________ b.) PNA No.: 19071 _______
Valid Until: Lifetime_____ _______ c.) ANSAP No.: ____________________________ Valid Until: Lifetime _______
Valid Until: ________________________________ c.) ADPCN No.: __0786_____________
Valid Until: _______________________