UNION CHRISTIAN COLLEGE

San Fernando City, La Union

Name of Student: Aguila, Jefferson Gomez
Name and Address of School: UNION CHRISTIAN COLLEGE, Widdoes Street, San Fernando City, 2500, La Union
Accreditation Level (if any): Level II Year Granted: 1999
Date School/Program was Recognized: June 14 Number: 198 Year: 1977
First Course (if any): Not Applicable School graduated from: Not Applicable Year: Not Applicable
Year of Admission in the Bachelor of Science in Nursing Program: 2003
Year Graduated (BSN Program): 2007
I. MAJOR OPERATIONS
No Date of Case No. Name of Patient Diagnosis Operation Type of Name of Name of Supervised Name &
. Operation Performed Anesthesia Surgeon Hospital by: Signature of
Name & O.R. Scrub
Signature of Nurse
Qualified
C.I.

Pregnancy Uterine 38 Emergency Subarachnoid Geraldine Ilocos Training Flordeliza G. Salvador

1 December 27, 2005- Annabelle Tominez weeks Age of Gestation Laterotransverse Block Kadatar, MD and Regional Galvez Somera
2006 0015157 Galvez secondary to Breech Cesarean Section with Medical Center PRC No.: 0130411 PRC No.: 0305596
PNA No.: 16263
Footling Gravida 2 Para 1 Bilateral Tubal Ligation (ITRMC) MAN units: 33 units
(G2P1)

2 July 15, 2006 2006- Evangeline Arapan Pregnancy Uterine Full Emergency Subarachnoid Joyce Bastian, Ilocos Training Flordeliza G. Felix Leo
0014883 Avecilla Term Cephalic in Labor Laterotransverse Block MD and Regional Galvez Aragon
Gravida 1 Para 0 (G1P0) in Cesarean Section Medical Center PRC No.: 0130411 PRC No.: 0162093
PNA No.: 16263
Fetal Distress (ITRMC) MAN units: 33 units

3 July 13, 2006 2001-25450 Marcelino Rivera Skull Fracture secondary to Emergency General Sixto Ordoño, Ilocos Training Flordeliza G. Alma Marquez
Peralta Fall Craniectomy Endotracheal MD and Regional Galvez PRC No.: 0340908
Anesthesia Medical Center PRC No.: 0130411
PNA No.: 16263
(ITRMC) MAN units: 33 units

4 July 7,2006 2006- Geron Taungay Laus Corneoscleral Laceration Emergency Repair of General Sebastian Ilocos Training Flordeliza G. Romel Lucina
0015716 with Iris Prolapsed Left Eye Corneoscleral Endotracheal Isagani Moll Jr., and Regional Galvez PRC No.: 325165
Laceration with Anesthesia MD Medical Center PRC No.: 0130411
PNA No.: 16263
Peripheral Iridectomy (ITRMC) MAN units: 33 units

5 July 6, 2006 2006- Jethly Dupala Mandibular Fracture Open Reduction General Pedro Patao, MD Ilocos Training Flordeliza G. Alma Marquez
0014795 Agbusac Internal Fixation with Endotracheal and Regional Galvez PRC No.: 0340908
Mandibular Plating Anesthesia Medical Center PRC No.: 0130411
PNA No.: 16263
(ITRMC) MAN units: 33 units
Prepared by:

AGUILA, Jefferson G.
Name of Student

Noted by: Concurred by: Approved by:

 NORBERTO G. PREPOSE, JR., RN, MAN FLORDELIZA R. BOBILES, RN, MAN MARITES G. CALUGAN, RN, MAN
CRISTETA E. BAGTANG, RN, MPH, MAN
Signature over printed Name of Clinical Coordinator Signature over printed name of Assistant Chief Nurse Signature over printed name of Chief Nurse Signature over
printed Name of Dean
Date Signed: ________________________ Date Signed: _____________________ Date Signed: ________________________ Date Signed:
_____________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN, RN, MAN Degree: BSN,
RN, MPH, MAN
a. PRC No.: 0209483 a. PRC NO.: 0114833 a. PRC NO.: 0166707 a. PRC NO.:
125448
Valid Until: April 2, 2009 Valid Until: March 27, 2008 Valid Until: May 16, 2009 Valid Until:
October 24, 2009
b. PNA No.: 16232 b. PNA No.: 17945 b. PNA No.: 14801 b. PNA No.: 3051
Valid Until: December 2007 Valid Until: Lifetime Member Valid Until: Lifetime Member Valid Until:
Lifetime Member
c. ANSAP No: 00077 c. ANSAP No: 01324 c. ANSAP No.: 02252 c. ADPCN No.:
356
Valid Until: Lifetime Member Valid Until: December 2007 Valid Until: December 2007 Valid Until:
December 2007