PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St.

, Sampaloc, Manila

COLLEGE OF NURSING
PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR NURSES LICENSURE EXAMINATION

Name of Student: MILLAN, JUSTINE URBI Name and Address of School: _Perpetual Help College Manila - Sampaloc, Manila Date School/Program was Recognized: _1985_____________________________ Number: 117 Year of Admission in the Bachelor of Science in Nursing Program: JUNE 2007 Year Graduated (BSN Program): APRIL 2011

MAJOR OPERATIONS
No. Date of Operation February 26,2011 1 2 March 19,2011 July 18,2011 3 July 19,2011 4 July 19,2011 5 859935 Napoleon Telesfono Indirect Inguinal Hernia, Left Mesh Herniorrhaphy, Left Subarachnoid Block Dr. Daniel Dela Paz 895166 Danilo Mirasol Cystolithiasis Cystolithotomy Subarachnoid Block 732837 Lerma Ureta Acute Appendicitis Case No. 844325 Name of Patient Josefina Pao Diagnosis Molar Pregnancy Operation Performed Emergency Total Abdominal Hysterectomy Bilateral SalpingoOophorectomy Emergency Appendectomy Mesh Herniorrhaphy, Left Type of Anesthesia General Endotracheal Anesthesia Subarachnoid Block Name of Surgeon Dr. Dianne Manzano Dr. Tito Apollo Quitoniano Dr. Daniel Dela Paz Dr. Juvido Agatep Name of Hospital East Avenue Medical Center East Avenue Medical Center East Avenue Medical Center East Avenue Medical Center East Avenue Medical Center Name of O.R. Scrub Nurse Gina C. Ladanan,RN Supervised by Qualified Clinical Instructor Gina C. Ladanan,RN

Anne Lawrence Buiser, RN Eduardo Prada,RN Randy Necesia,R.N Eduardo Prada,R.N

Lelita P. Tadifa, RN,MAN,Phd

859789

Ruben Fabia

Indirect Inguinal Hernia, Left

Subarachnoid Block

Lelita P. Tadifa, RN,MAN,Phd Lelita P. Tadifa, RN,MAN,Phd Lelita P. Tadifa, RN,MAN,Phd

Noted by: MRS. NELIA S. COTORNO,RN,MAN Signature over Printed Name of Clinical Coordinator Date Signed: Degree: RN, MAN a. PRC No.: 0145558 Valid until: January 24,2013

Concurred by: MRS. NORA L. DIAZ, RN, MAN Signature over Printed Name of Chief Nurse in East Avenue Medical Center Date Signed: Degree: RN, MAN PRC No.: 45102 Valid until: 2011 b. PNA No.: 14597 Valid until: Lifetime

Approved by: MRS. MELINDA I. GABLAN, RN, MAN Signature over Printed Name of Dean Date Signed: Degree: BSN, RN, MAN a. PRC No.: 124488 Valid until: 2013 b. PNA No.: 17852 Valid until: Lifetime c. ADPCN No.: 11-195 Valid until: 2014

a.

b.

PNA No.: 17850 Valid until: Lifetime

PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St., Sampaloc, Manila

COLLEGE OF NURSING
PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR NURSES LICENSURE EXAMINATION

Name of Student: MILLAN, JUSTINE URBI Name and Address of School: _Perpetual Help College Manila - Sampaloc, Manila Date School/Program was Recognized: _1985 Number: 117 Year of Admission in the Bachelor of Science in Nursing Program: _JUNE 2007 Year Graduated (BSN Program): APRIL 2011 MINOR OPERATIONS
No. Date of Operation May 12,2010 1 May 12,2010 2 May 13,2010 3 May 14, 2010 4 March 19,2011 5 849163 Arnold de Dios 915601 055801 Margarito Macaranas Sammy Fernandez 905601 Case No. 605701 Name of Patient Marvin Kit Atchuela Ricky Carchero Diagnosis Redundant Prepuce Operation Performed Circumcision Type of Anesthesia Local Name of Surgeon Dr. Mar Joseph Florentino Dr. Mar Joseph Florentino Dr. Stephen Marcelo Dr. Jeffrey Rosuman Dr. Marc Domini Abad Name of Hospital Ospital ng Sampaloc Name of O.R. Scrub Nurse Ronnie Leon R. Salgado Jr., RN Ronnie Leon R. Salgado Jr., RN Ronnie Leon R. Salgado Jr., RN Ronnie Leon R. Salgado Jr., RN Christopher Estrella,RN Supervised by Qualified Clinical Instructor Ronnie Leon R. Salgado Jr., RN

Sebaceous cyst left temporary Cellulitis right leg

Excision

Local

Ospital ng Sampaloc

Ronnie Leon R. Salgado Jr., RN

Incision and Drainage

Local

Ospital ng Sampaloc

Ronnie Leon R. Salgado Jr., RN

Abscess 3rd digit right hand Uremia secondary to Chronic Kidney Disease

Incision and Debridement Intrajugular Catheter Insertion

Local Local

Ospitan ng Sampaloc East Avenue Medical Center

Ronnie Leon R. Salgado Jr., RN Lelita P. Tadifa, RN,MAN,Phd

Noted by: MRS. NELIA S. COTORNO,RN,MAN Signature over Printed Name of Clinical Coordinator Date Signed: Degree: RN, MAN a. PRC No.: 0145558 Valid until: January 24,2013

Concurred by: MRS. GRACE D. ZALDUA,RN,MAN Signature over Printed Name of Chief Nurse in Ospital ng Sampaloc Date Signed: Degree: RN, MAN a. PRC No.: 0142514 Valid until: May,2012 b. PNA No.: 15062 Valid until: Lifetime

Concurred by: MRS. NORA L. DIAZ, RN, MAN Signature over Printed Name of Chief Nurse in East Avenue Medical Center Date Signed: Degree: RN, MAN PRC No.: 45102 Valid until: 2011 b. PNA No.: 14597 Valid until: Lifetime

Approved by: MRS. MELINDA I. GABLAN, RN, MAN Signature over Printed Name of Dean Date Signed: Degree: BSN, RN, MAN a. PRC No.: 124488 Valid until: 2013 b . PNA No.: 17852 Valid until: Lifetime c. ADPCN No.: 11- 195 Valid until: 2014

a.

a.

PNA No.: 17850 Valid until: Lifetime

PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St., Sampaloc, Manila

COLLEGE OF NURSING
PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR NURSES LICENSURE EXAMINATION

Name of Student: MILLAN, JUSTINE URBI Name and Address of School: _Perpetual Help College Manila - Sampaloc, Manila Date School/Program was Recognized: _1985______________ Number:117 Year of Admission in the Bachelor of Science in Nursing Program: _JUNE 2007 Year Graduated (BSN Program): APRIL 2011

ACTUAL DELIVERIES
No. Case No. 8425-23 1 8745-57 2 14782602 3 Diagnosis Pregnancy uterine Full term 40 weeks age of gestation gravida1 Parity1 cephalic in labor Pregnancy uterine Full term 39 weeks age of gestation gravida2 Parity1 cephalic in labor Pregnancy uterine Full term 37 weeks age of gestation gravida4 Parity4 cephalic in labor Pregnancy uterine Full term 37-38 weeks age of gestation gravida4 Parity2 cephalic in labor Pregnancy uterine Full term 38-19 weeks age of gestation gravida2 Parity2 cephalic in labor Name of Mother Stephanie Hecto Princess Peralta Arrelyn Guerra Arleigh Fanuncio Sabrina Moreno 17 Age Date of Delivery August 2,2010 April 23, 2010 June 24,2011 July 13,2011 Time of Delivery 5:15 pm Type of Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Gender of Baby Male Name of Hospital F. Lanuza Lying-In Clinic Name of Qualified Clinical Instructor Monserat delos Reyes, RN,MAN Monserat delos Reyes, RN,MAN Juliana B. Revilla,RN,MAN Juliana B. Revilla,RN,MAN Juliana B. Revilla,RN,MAN Signature of Qualified Clinical Instructor

19 28 32

10:57am 10:40am 8:08pm

Female Male

F. Lanuza Lying-In Clinic Caloocan Puericulture Center and Maternity House Caloocan Puericulture Center and Maternity House Caloocan Puericulture Center and Maternity House

4 5

1478262 1 1478262 8

Female Male

26

July 19,2011

5:05 pm

Noted by: MRS. NELIA S. COTORNO,RN,MAN Signature over Printed Name of Clinical Coordinator Date Signed: Degree: RN, MAN a. PRC No.:0145558 Valid until: January 24,2011

Concurred by: MRS. MA.LYNNETTE J. GEMPERLE,M.D,MPH Signature over Printed Chief Training Office Manila Health Department Date Signed: Degree: MD,MPH a. PRC No.: 0060538 Valid until: January 4,2013 b. PNA No.: Valid until:

Concurred by: MRS. JOY LYNN G. GONZALES,MD Signature over Printed Chairman Affiliation and Training Committee Caloocan Puericulture and Maternity House Date Signed: Degree: MD b. PRC No.:104004 Valid until: August 2011 b. PNA No.: Valid until:

Approved by: MRS. MELINDA I. GABLAN, RN, MAN Signature over Printed Name of Dean Date Signed: Degree: BSN, RN, MAN a. PRC No.: 124488 Valid until: 2013 b. PNA No.: 17852 Valid until: Lifetime c. ADPCN No.:11-195 Valid until: 2014

b.

PNA No.: 17850 Valid until: Lifetime

PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St., Sampaloc, Manila

COLLEGE OF NURSING
PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR NURSES LICENSURE EXAMINATION

Name of Student: MILLAN, JUSTINE URBI Name and Address of School: _Perpetual Help College Manila - Sampaloc, Manila Date School/Program was Recognized: _1985______________ Number:117 Year of Admission in the Bachelor of Science in Nursing Program: _JUNE 2007 Year Graduated (BSN Program): APRIL 2011

CORD DRESSING
No. 1 8441-39 2 1061262 3 105784 November 19, 2010 February 24, 2011 November 13,2010 Bb.Boy Simbillo Bb. Boy Lacsa February 24, 2011 Male Male Female Celine Simbillo Marisa Lacsa Mary Grace Hilario 19 32 34 Gat Andres Memorial Medical Center Gat Andres Memorial Medical Center Gat Andres Memorial Medical Center Evangeline S. Salas, RN, MAN Evangeline S. Salas, RN, MAN Evangeline S. Salas, RN, MAN August 9,2010 Bb. Boy Rio Male Julie Ann Rio 24 F. Lanuza Lying-In Clinic Monserat delos Reyes, RN,MAN Case No. 8439-37 Date Performed August 9,2010 Name of Baby Bb. Boy Orias Gender of Baby Male Name of Mother Lowela Orias Age 28 Name of Hospital F. Lanuza Lying-In Clinic Name of Qualified Clinical Instructor Monserat delos Reyes, RN,MAN Signature of Qualified Clinical Instructor

4
107675

Noted by: MRS. NELIA S. COTORNO,RN,MAN Signature over Printed Name of Clinical Coordinator Date Signed: Degree: RN, MAN b. PRC No.:0145558 Valid until: January 24,2011

Concurred by: MRS. MA.LYNNETTE J. GEMPERLE,M.D,MPH Signature over Printed Chief Training Office Manila Health Department Date Signed: Degree: MD,MPH c. PRC No.: 0060538 Valid until: January 4,2013 b. PNA No.: Valid until:

Concurred by: MRS. PRESCILA A. EUSTAQUIO, RN, MSN Signature over Printed Name of Chief Nurse in Gat Andres Memorial Medical Center Date Signed: Degree: RN,MSN a. PRC No.:0160188 Valid until: June 26,2011 b. PNA No.: 15553 Valid Until :Lifetime c. ANSAP No.: 00694 Valid Until: Lifetime

Approved by: MRS. MELINDA I. GABLAN, RN, MAN Signature over Printed Name of Dean Date Signed: Degree: BSN, RN, MAN d. PRC No.: 124488 Valid until: 2013 b. PNA No.: 17852 Valid until: Lifetime f. ADPCN No.:11-195 Valid until: 2014

e.

PNA No.: 17850 Valid until: Lifetime

PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St., Sampaloc, Manila

COLLEGE OF NURSING
PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR NURSES LICENSURE EXAMINATION

Name of Student: _MILLAN, JUSTINE URBI Name and Address of School: _Perpetual Help College Manila - Sampaloc, Manila Date School/Program was Recognized: _1985_____________________________ Number: 117 Year of Admission in the Bachelor of Science in Nursing Program: _JUNE 2007 Year Graduated (BSN Program): APRIL 2011

DELIVERIES ASSISTED
No. Case No. Diagnosis Name of Mother Katherine Francisco Anabelle Lazaro Mary Joy Dominguez Me-chelle Bunao 29 Age Date of Delivery August 10,2010 August 11,2010 June 27,2011 March 18,2011 Time of Delivery 3:20pm Type of Delivery Gender of Baby Female Name of Hospital Name of Qualified Clinical Instructor Monserat delos Reyes, RN,MAN Monserat delos Reyes, RN,MAN Juliana B. Revilla,RN,MAN Signature of Qualified Clinical Instructor

8444-42 1 8446-44 2 14782603 3 793438 4 5

Pregnancy uterine Full term 39 weeks age of gestation gravida4 Parity4 cephalic in labor Pregnancy uterine Full term 37 weeks age of gestation gravida2 Paruty2 cephalic in labor Pregnancy uterine Full term 3940 weeks age of gestation gravida1 Parity1 cephalic in labor Pregnancy uterine Full term 41 weeks age of gestation gravida1 Parity0 cephalic in labor

Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery Normal Spontaneous Delivery

F. Lanuza Lying-In Clinic

20

9:38 pm

Male

F. Lanuza Lying-In Clinic

16

2:35pm

Female

Caloocan Puericulture Center and Maternity House East Avenue Medical Center

26

4:25pm

Male

Lelita P. Tadifa,RN,MAN,Phd

PERPETUAL HELP COLLEGE MANILA 1240 V. Concepcion St., Sampaloc, Manila

COLLEGE OF NURSING
Noted by: MRS. NELIA S. COTORNO,RN,MAN Signature over Printed Name of Clinical Coordinator Date Signed: Degree: RN, MAN Concurred by:

PROFESSIONAL REGULATION COMMISSION REQUIREMENTS FOR Concurred by: NURSES LICENSURE EXAMINATION Concurred by:
MRS. NORA L. DIAZ, RN, MAN Signature over Printed Name of Chief Nurse in East Avenue Medical Center Date Signed: Degree: RN, MAN MRS. JOY LYNN G. GONZALES,MD Signature over Printed Chairman Affiliation and Training Committee Caloocan Puericulture and Maternity House Date Signed: Degree: BSN, RN, MAN

Approved by: MRS. MELINDA I. GABLAN, RN, MAN Signature over Printed Name of Dean Date Signed: Degree: BSN, RN, MAN a. PRC No.: 124488 Valid until: 2013 b. PNA No.: 17852 Valid until: Lifetime e. ADPCN No.: 11-195 Valid until: 2014

MRS. MA. LYNNETTE J. GEMPERLE,MD,MPH Signature over Printed Chief Training Office Manila Health Department Date Signed: Degree: RN, MSN

a. b.

PRC No.: 0145558 Valid until: January 24, 2013 PNA No.: 17850 Valid until: Lifetime

a. b.
d.

PRC No.: 0160188 Valid until: June 26, 2011 PNA No.: 15553 Valid until: Lifetime ANSAP No.: 00694 Valid until: Lifetime

a. PRC No.: 051967 Valid until: Oct. 2012 c.

PNA No.: 14415 Valid until: Lifetime

a. PRC No. 142514 Valid until: May 2012 c. PNA No. 15062 Valid until: Lifetime