The Philippine Women's University

The Philippine Womens University
and its Affiliate Schools for Men and Women

1743 Taft Avenue, Manila, Philippines 1004
Granted Autonomous Status by the Commission on Higher Education in June 2008
Name of Student: _Tomas, Marconi M.__________________________________________________________________________________________________________________

Name & Address of School: _The Philippine Womens University, Taft Avenue Manila_________________________________________________________________________
Accreditation Level (if any): _Level II PAASCU Re-accredited____________________ Year Granted: _November 23, 2007_________________________________________
Date School/ Program was Recognized: _July 01, 1968____________
Number: _S-289___________________ Year: _1968_________________________________
First Course (if any): _None________________ School Graduated From: _Not Applicable__________________ Year: _Not Applicable_____________________________
Year of Admission in the Bachelor of Science in Nursing Program: _June 2008________________________________________________________________________________
Year Graduated (BSN Program): _September 03, 2011____________________________________________________________________________________________________
No.
I.
Major Operations
Operation Performed
Case
No.
Name of Patient
Diagnosis
1.
Date
of
Operation
01/13/11
A095414
Evelyn Esguerra
Diabetes mellitus Left (L) foot
Below Knee Amputation Left (L)
2.
01/13/11
A-068975
Glena A. Gadut
Gravida Three (3) Parity Three (3), Pregnancy

Uterine Full Term Delivery to a Live Baby Boy
3.
03/21/11
26003
Alma Veceina
Meningioma Right (R) Temporal Area
Repeat Lower Segment Caesarean

Section (LSCS) and Ligation of Right
(R) Fallopian Tube
Craniotomy and Excision of
Hemangioma and Duraplasty
4.
03/28/11
A097052
Jamina
Monalocon
Gravida Two (2) Parity Zero (0) (0010)

Pregnancy Uterine, Thirty-Two (32)
One/Seventh (1/7) weeks, Age Of Gestation by
Last Menstrual Period, Transverse in Labor
Nasal Polyps Gr. II Right (R)
5.
03/29/11
6788
Cefirino Plana Jr
Prepared by:
______________________
MARCONI M. TOMAS
Student Nurse
Gravida Two (2) Parity One (1)

Pregnancy Uterine, Preterm Delivery
via Lower Segment Caesarean Section
to a Live Baby Boy
Functional Endoscopic Sinus Surgery
Noted by:
______________________
MYRNA S. RIVERA
Clinical Coordinator, PWU
Date Signed: ____________
Degree: _RN, MAN_______
a) PRC No.: _70309_______
Valid until: _March 28, 2012
b) PNA No.: _16969_______
Valid until: _Lifetime______
Type of
Anesthesia
Name of Surgeon
Name of
Hospital
Name of O.R.
Scrub Nurse
SubArachnoid
Block
SubArachnoid
Block
General
Endotracheal
Anesthesia
Spinal
Anesthesia
Dr. Jaimee
L.Tamayo
Rizal Medical
Center
Benedicto A.
Josef JR.
Dr. Lilian A.
Rodrigo
Rizal Medical
Center
Vicente D.
Morato
Dr. Almario G.
Jabson
Rizal Medical
Center
Cecilia C. Sube
Supervised by: Name &

Signature Clinical Instructor
Melva S. Bonifacio, RN MAN

Dr. Lilian A.
Rodrigo
Rizal
Joel
Medical
I. Torres
Center
General
Endotracheal
Anesthesia
Dr. Lean Melissa

Samio
Concurred by:
_____________________________
LOUISE MARIE D. FLORES
Chief Nurse of Rizal Medical Center
Date Signed: ________________
Degree: _ RN, MAN, DPA_____
a) PRC No.: _0086759_______
Valid until: _ March 18, 2012__
b) PNA No.: _10355_________
Valid until: _Lifetime__________
c) ANSAP No.: _0316________
Rizal Medical
Center
Delrine Rose M.
De Jesus
Approved by:
MA.
EDNA F. DOMINGUEZ
__________________________
Dean, College of Nursing PWU
Date Signed: ______________
Degree: _RN, MAN_________
a) PRC No: _0111067______
Valid until: _Nov. 8, 2014____
b) PNA No.: _18720_______
Valid until: _Lifetime_______
c) ADPCN No.: _18338_____
Valid until: _May 31, 2012___


Number: _S-289___________________ Year: _1968_________________________________
No.
II. Minor Operations

Operation Performed
Type of
Anesthesia
Case
No.
Name of Patient
Diagnosis
1.
Date
of
Operation
01/19/11
9653
2.
01/19/11
9373
Margarita San Jun

Balitos
Jomar Pario Lola
3.
01/26/11
A-095754
Rebecca Ison
Sebaceous Cyst Left (L)

Knee
Lipoma Left (L)
Scapular Area
Right (R) Colonic Mass
Excision of Cyst Left (L)

Knee
Excision of Mass Left (L)
Scapular Area
Colonoscopy
03/03/11
A-096714
Prince Cedrick F.
Abal
Rectal Polyp
Polypectomy
08/25/11
08148
Apple Labor
Foreign Body (Bullet)

Distal Forearm Left (L)
Removal of Foreign Body
4.
5.
Prepared by:
______________________
MARCONI M. TOMAS
Student Nurse
Noted by:
______________________
MYRNA S. RIVERA
a) PRC No.: _70309_______
b) PNA No.: _16969_______
Name of Surgeon
Name of
Hospital
Name of O.R.
Scrub Nurse
Local
Anesthesia
Local
Anesthesia
IV-Sedation
Dr. Marc Paul G. Pestao
Jerico P. Catoc
General
Anesthesia
Mask
Local
Anesthesia
Dr. Jondav A. Martinez
Rizal Medical
Center
Rizal Medical
Center
Rizal Medical
Center
Rizal Medical
Center
Dr. Marc Paul G. Pestao

Dr. Ray I. Sarmiento
Supervised by: Name &

Signature Clinical Instructor
Minerva B. de Ala, RN MAN
Jerico P. Catoc
Armida I. Cango
Mary Grace
Lanzanas Rivera
Dr. Adjarael Jomal V. Malali
Concurred by:
_____________________________
Date Signed: ________________
a) PRC No.: _0086759_______
b) PNA No.: _10355_________
c) ANSAP No.: _0316________
Rizal Medical
Center
Jerico P. Catoc
Approved by:
__________________________
MA. EDNA F. DOMINGUEZ
Date Signed: ______________
a) PRC No: _0111067______
b) PNA No.: _18720_______
c) ADPCN No.: _18338_____


Number: _S-289___________________ Year: _1968_________________________________
No.
Case No.
Diagnosis
Name of Mother
Age
1.
414464
Gravida One (1) Parity One (1) Pregnancy Uterine, Forty (40)
One/Seventh (1/7) weeks, Age Of Gestation, Cephalic In Labor
Rochelle Merilles
24
Gravida One (1) Parity Zero (0) Pregnancy Uterine, Thirty-Six

(36) Two/Seventh (2/7) weeks, Age Of Gestation
Evelyn Sampage
Gravida Two (2) Parity One (1)(1001) Pregnancy Uterine,

Thirty-Eight (38) One/Seventh (1/7) weeks, Age Of Gestation
by Last Menstrual Period, Cephalic In Labor
Jacqueline Hasim
Gravida Five (5) Parity Five (5) Pregnancy Uterine, Forty (40)
weeks, Age Of Gestation
Ma. Victoria Cerillo
Gravida One (1) Parity One (1) Pregnancy Uterine, ThirtyEight (38) Four/Seventh (4/7) weeks, Age Of Gestation
Ma. Consuelo Carael
2.
3.
4.
5.
58988
A098527
417996
397777
Prepared by:
______________________
MARCONI M. TOMAS
Student Nurse
Noted by:
______________________
MYRNA
S. RIVERA
a) PRC No.: _70309_______
b) PNA No.: _16969_______
19
21
31
15
III. Actual Deliveries

Date of
Time of
Delivery
Delivery
08/01/11
08/29/11
08/16/11
09/15/11
09/15/11
Gender of
Baby
Name of Hospital
Type of Delivery
Male
Dr. Jose Fabella

Memorial Hospital
Normal Spontaneous
Delivery
Rizal Medical Center
Normal Spontaneous
Delivery
07:43 p.m.
11:30 p.m.
05:28 p.m.
04:30 p.m.
05:12 p.m.
Male
Female
Female
Male
Normal Spontaneous
Delivery
Dr. Jose Fabella

Memorial Hospital
Normal Spontaneous
Delivery
Dr. Jose Fabella

Memorial Hospital
Normal Spontaneous
Delivery
Concurred by:
Janette M. Carlos, RM
Gregorio A. Mendoza III, RN MAN
Herminigilda A. Dayao, RN
Herminigilda A. Dayao, RN
Approved by:
_____________________________
_____________________________

MARIE THERESE A. PACABIS

Chief Nurse of Dr. Jose Fabella
Memorial Hospital
Date Signed: ________________

Date Signed: ________________
a) PRC No.: _0086759_______
b) PNA No.: _10355_________
c) ANSAP No.: _0316________
Supervised by: Name & Signature

Clinical Instructor
Degree: _ RN, MAN ___________

d) PRC No.: _0039563________
Valid until: _October 12, 2012___
e) PNA No.: _18153__________
f) ANSAP No.: _257__________

Dean,
College of Nursing PWU
__________________________
Date Signed: ______________
a) PRC No: _0111067______
b) PNA No.: _18720_______
c) ADPCN No.: _18338_____


Number: _S-289___________________ Year: _1968_________________________________
No.
Case No.
Diagnosis
Name of Patient
1.
A096412
Gravida Two (2) Parity One (1) (2002) Thirty-Seven (37) weeks, Age
Of Gestation, Cephalic In Labor
Clarisse Adao
Gravida One (1) Parity One (1) Pregnancy Uterine, Thirty-Nine (39)
Five/Seventh (5/7) weeks, Age Of Gestation, Cephalic In Labor
Rachelle Marianne
Manaois
Gravida Two (2) Parity One (1) (1001) Thirty-Seven 37 weeks, Age Of
Gestation, by Ultrasound Oligohydramnios
Myla Gonzales
Gravida Two (2) Parity One (1) (1001) Pregnancy Uterine, Thirty-Nine
(39) weeks, Age Of Gestation, Cephalic In Labor Imminent Delivery
Estrella Griotal
Gravida One (1) Parity Zero (0) Pregnancy Uterine, Thirty-Two (32)
Three/Seventh (3/7) weeks, Age Of Gestation by Last Menstrual Period,
Cephalic In Labor Imminent Delivery
Maribel Galang
2.
3.
4.
5.
400784
A098628
50742
A098759
Prepared by:
______________________
MARCONI M. TOMAS
Student Nurse
Noted by:
______________________
MYRNA S. RIVERA
a) PRC No.: _70309_______
b) PNA No.: _16969_______
IV. Deliveries Assisted

Age
Date of
Time of
Delivery
Delivery
21
19
24
29
21
02/17/11
08/01/11
08/22/11
08/22/11
08/31/11
12:05 a.m.
03:36 p.m.
10:18 p.m.
04:25 p.m.
03:54 a.m.
Gender of
Baby
Name of Hospital
Type of
Delivery
Female
Normal
Spontaneous
Delivery
Male
Female
Female
Male
Dr. Jose Fabella

Memorial Hospital
Normal
Spontaneous
Delivery
Normal
Spontaneous
Delivery
Concurred by:
Normal
Spontaneous
Delivery
Normal
Spontaneous
Delivery
Janette M. Carlos, RM
Approved by:
_____________________________
_____________________________

MARIE THERESE A. PACABIS

Chief Nurse of Dr. Jose Fabella
Memorial Hospital
Date Signed: ________________

Date Signed: ________________
a) PRC No.: _0086759_______
b) PNA No.: _10355_________
c) ANSAP No.: _0316________

of Qualified Clinical Instructor
Degree: _ RN, MAN ___________

d) PRC No.: _0039563________
Valid until: _October 12, 2012___
e) PNA No.: _18153__________
f) ANSAP No.: _257__________

Dean,
College of Nursing PWU
__________________________
Date Signed: ______________
a) PRC No: _0111067______
b) PNA No.: _18720_______
c) ADPCN No.: _18338_____


Number: _S-289___________________ Year: _1968_________________________________
No.
Case No.
Date
Performed
Name of Baby
Gender of
Baby
1.
60442
08/17/11
Baby Boy Sumapal
Male
2.
50770
08/17/11
Baby Girl Go
3.
52534
08/22/11
4.
54063
5.
A0985759
V. Cord Dressing
Name of Mother
Age
Name of Hospital
Noemeriza Sumapal
27
Female
Virginia Camarao Go
32
Baby Girl Mendoza
Female
Cristina Mendoza
28
08/22/11
Baby Girl Labjata
Female
Riza Crizel Labjata
26
08/31/11
Baby Boy Chan
Male
Ma. Pacencia Chan
38
Prepared by:
______________________
MARCONI M. TOMAS
Student Nurse
Noted by:
Concurred by:
MYRNA S. RIVERA
______________________
Clinical
Coordinator, PWU
_____________________________


a) PRC No.: _70309_______
b) PNA No.: _16969_______
Date Signed: ________________

a) PRC No.: _0086759_______
b) PNA No.: _10355_________
c) ANSAP No.: _0316________

of Qualified Clinical Instructor
Marilyn D. Dorol, RN MAN
Marilyn D. Dorol, RN MAN
Approved by:
__________________________
Date Signed: ______________
a) PRC No: _0111067______
b) PNA No.: _18720_______
c) ADPCN No.: _18338_____

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The Philippine Women's University

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The Philippine Womens University

and its Affiliate Schools for Men and Women

Name of Student: _Tomas, Marconi M.__________________________________________________________________________________________________________________

Diabetes mellitus Left (L) foot

Below Knee Amputation Left (L)

Gravida Three (3) Parity Three (3), Pregnancy

Meningioma Right (R) Temporal Area

Repeat Lower Segment Caesarean

Gravida Two (2) Parity Zero (0) (0010)

Gravida Two (2) Parity One (1)

Supervised by: Name &

Melva S. Bonifacio, RN MAN

Dr. Lean Melissa