XAVIER UNIVERSITY – ATENEO DE CAGAYAN

Corrales Avenue, Cagayan de Oro City, Philippines

School Code: 0839

Name of Student: PAULA HELENA ROJAS ABA

Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City
Accreditation Level (if any): None Year Granted: Not Applicable
Date of School / Program was Recognized: June 9 Number: 008 Year: 1992
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: 2005
Year Graduated (BSN Program): 2009

III. HANDLED DELIVERIES

Time
Gende Supervised by:
Case Name of Date of of Name of
Number Diagnosis Age r of Type of Delivery Name & Signature of Qualified
Number Patient Delivery Delive Hospital
Baby C.I.
ry
Delivery Term Spontaneous to
Normal
an alive baby girl 2.8 Lady June Gingoog District
1 248374 21 April 21, 2009 5:25pm Female Spontaneous
kilograms with APGAR Score of Balacuit Hospital Mrs. Christy G. Dablo, BSN, RN, MN,
Vaginal Delivery
9 cephalic Gravida 1 Parity 1 MAN
Delivery Term Spontaneous to
Normal
an alive baby boy 3.0 Marilyn 10:20p Gingoog District
2 25 April 24, 2009 Male Spontaneous
224755 kilograms with APGAR Score of Fernandez m Hospital Mrs. Christy G. Dablo, BSN, RN, MN,
Vaginal Delivery
9 cephalic Gravida 2 Parity 1 MAN
Delivery Term Spontaneous to
Normal
248554 an alive baby boy 3.0 Jonalyn Gingoog District
3 23 April 26, 2009 1:30pm Male Spontaneous
kilograms with APGAR Score of Balatero Hospital Mrs. Christy G. Dablo, BSN, RN, MN,
Vaginal Delivery
9 cephalic Gravida 1 Parity 0 MAN
Delivery Term Spontaneous to
Normal
245826 an alive baby boy 3.0 Eusebia 12:43a Gingoog District
4 27 May 2, 2009 Male Spontaneous
kilograms with APGAR Score of Ragot m Hospital Mrs. Christy G. Dablo, BSN, RN, MN,
Vaginal Delivery
9 cephalic Gravida 3 Parity 3 MAN
Delivery Term Spontaneous to
Normal
241938 an alive baby girl 3.0 10:00p Gingoog District
5 Riza Pagaran 30 May 3, 2009 Female Spontaneous
kilograms with APGAR Score of m Hospital Mrs. Christy G. Dablo, BSN, RN, MN,
Vaginal Delivery
9 cephalic Gravida 4 Parity 3 MAN

Valid Until: November 22, 2010 Chief Nurse

Prepared by: . Gingoog District Hospital
Noted by: b.) PNA No.: 066620 Date Signed:
___PAULA HELENA ROJAS
.
ABA___ _________MRS. CHRISTY G.
Valid Until: December 31, 2009 .
Name of Student DABLO________
. Degree: BSN, RN
Clinical Coordinator
.
Date Signed:
a.) PRC No.: 0077182
.
. Valid Until: December 10, 2010
Degree: BSN, RN, MN, MAN .
. b.) PNA No.: 80212
Concurred by:
a.) PRC No.: 0222342 .
Valid Until: December 31, 2009
. ___________MRS. JULIANA L.
.
JAVIER___________
Approved by:

________DR. RAMONA HEIDI C.

PALAD________
Dean College of Nursing
Xavier University- Ateneo de
Cagayan
Date Signed:
.
Degree: BSN, RN, MAN, MAed, PhD
.
a.) PRC No.: 0053722
.
Valid Until: August 31, 2012
.
b.) PNA No.: 11836
.
Valid Until: Lifetime
.
c.) ADPCN No.: 0063
.
Valid Until: October 31, 2010
.
 XAVIER UNIVERSITY – ATENEO DE CAGAYAN
Corrales Avenue, Cagayan de Oro City, Philippines
School Code: 0839

Name of Student: PAULA HELENA ROJAS ABA

Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City
Accreditation Level (if any): None Year Granted: Not Applicable
Date of School / Program was Recognized: June 9 Number: 008 Year: 1992
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: 2005
Year Graduated (BSN Program): 2009

IV. DELIVERIES ASSISTED

Time
Gende Supervised by:
Case Name of Date of of Name of
Number Diagnosis Age r of Type of Delivery Name & Signature of Qualified
Number Patient Delivery Deliver Hospital
Baby Clinical Instructor
y
Northern Normal
Inevitable Abortion, G4P3 Marivic
1 27 May 8, 2008 1:26pm Male Mindanao Spontaneous
508349 (3003) Aguiton
Medical Center Vaginal Delivery
Mrs. Jessica D. Bunao, BSN, RN
Delivery Term Spontaneous to
Normal
an alive baby girl 3.0 Angelita April 23, Gingoog District
2 229708 42 9:45am Female Spontaneous
kilograms with APGAR Score of Sabuga 2009 Hospital Mrs. Christy G. Dablo, BSN, RN,
Vaginal Delivery
9 cephalic Gravida 4 Parity 3 MN, MAN
Delivery Term Spontaneous to
an alive baby boy 2.6 Maria Normal
April 25, Gingoog District
3 226758 kilograms with APGAR score of Bernadette 19 7:43am Male Spontaneous
2009 Hospital
9 cephalic Gravida 1 Para 1 Oncada Vaginal Delivery Mrs. Christy G. Dablo, BSN, RN,
(1001) MN, MAN
Delivery Term Spontaneous to Gingoog City
Normal
an alive baby girl 3.4 April 27, Women &
4 1891 Jodeza Peligro 25 5:23pm Female Spontaneous
kilograms with APGAR Score of 2009 Puericulture Mrs. Christy G. Dablo, BSN, RN,
Vaginal Delivery
9 cephalic Gravida 1 Parity 0 Center MN, MAN
Delivery Term Spontaneous to
Normal
an alive baby girl 3 kilograms Delma Faith Gingoog District
5 226258 24 May 3, 2009 6:00pm Female Spontaneous
with APGAR Score of 9 Aviancio Hospital Mrs. Christy G. Dablo, BSN, RN,
Vaginal Delivery
cephalic Gravida 2 Parity 1 MN, MAN

Prepared by: Date Signed: Valid Until: December 31, __ DR. DOROTHEA N. Valid Until: February 6, 2010
2009 . ROQUE_____ .
___ PAULA HELENA ROJAS Chief Nurse b.) PNA No.: 018604
.
ABA____ Northern Mindanao Medical .
Degree: BSN, RN, MN, MAN
Name of Student Center Valid Until: December 31,
.
Date Signed: 2009 .
a.) PRC No.: 0222342 c.) ANSAP No.: 05047
Noted by: . .
.
Valid Until: November 22, Valid Until: December 31,
Degree: BSN, RN, MAN, Ed D.
_ ___MRS.CHRISTY G. 2010 . Concurred by: 2009 .
.
DABLO_______ b.) PNA No.: 066620 a.) PRC No.: 0041397
Clinical Coordinator
. .
 ____DR. RAMONA HEIDI C.
PALAD_____
Concurred by: Dean College of Nursing
Xavier University-Ateneo de
_______MRS. JULIANA L. Cagayan
JAVIER______ Date Signed:
Chief Nurse
Gingoog District Hospital
.
Date Signed:
Degree: BSN, RN, MAN, MAEd,
PhD .
. a.) PRC No.: 0053722
Degree: BSN, RN
.
.
Valid Until: August 31, 2012
a.) PRC No.: 0077182 .
. b.) PNA No.: 11836
Valid Until: December 10,
.
2010 .
Valid Until: Lifetime
b.) PNA No.: 80212 .
. c.) ADPCN No.: 0063
Valid Until: December 31,
.
2009 .
Valid Until: October 31, 2010
.

Concurred by:

_________MS. RIZA C.
DAJAO_________
Nurse
Gingoog City Women &
Puericulture Center
Date Signed:

.
Degree: RM, RN
.
a.) PRC No.: 0349503
.
Valid Until: August 25, 2012
.
b.) PNA No.: 066466
.
Valid Until: December 4,
2010 .

Approved by:
 XAVIER UNIVERSITY – ATENEO DE CAGAYAN
Corrales Avenue, Cagayan de Oro City, Philippines
School Code: 0839

Name of Student: PAULA HELENA ROJAS ABA

Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City
Accreditation Level (if any): None Year Granted: Not Applicable
Date of School / Program was Recognized: June 9 Number: 008 Year: 1992
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: 2005
Year Graduated (BSN Program): 2009

V. CORD DRESSING
Case Date Gender of Supervised by:
Number Name of Baby Name of Mother Age Name of Hospital
Number Performed Baby Name & Signature of Qualified C.I.

Madonna and Child

1 2081295 April 21, 2008 Baby Boy Bernadez Male Fe Bernadez 35
Hospital
Mrs. Rosalie A. Uriarte, BSN, RN

2 248386 April 21, 2009 Baby Girl Ragot Female Marshaliza Ragot 32 Gingoog District Hospital
Mrs. Christy G. Dablo, BSN, RN, MN,
MAN

3 248385 April 21, 2009 Baby Boy Castil Male Renie Macaranas 35 Gingoog District Hospital
Mrs. Christy G. Dablo, BSN, RN, MN,
MAN

4 248388 April 21, 2009 Baby Boy Salugsugan Male Elcita Salugsugan 31 Gingoog District Hospital
Mrs. Christy G. Dablo, BSN, RN, MN,
MAN

5 248731 May 5, 2009 Baby Girl Pagapong Female Evelyn Pagapong 31 Gingoog District Hospital
Mrs. Christy G. Dablo, BSN, RN, MN,
MAN
 Prepared by: Noted by: Concurred by: Concurred by: Approved by:

PAULA HELENA ROJAS ________MRS.CHRISTY G. _ MS. FRANCES ROSARY C. _ MRS. JULIANA L. __ DR. RAMONA HEIDI C.
ABA_____ DABLO__________ MARFORI____ JAVIER____ _______ PALAD________
Name of Student Clinical Coordinator Chief Nurse Chief Nurse Dean College of Nursing
Date Signed: Madonna and Child Hospital Gingoog District Hospital Xavier University-Ateneo de
Date Signed: Date Signed: Cagayan
Date Signed:
.
Degree: BSN, RN, MN, MAN . Degree: BSN, RN, MN .
. . Degree: BSN, RN .
a.) PRC No.: 0222342 a.) PRC No.: 0164585 . Degree: BSN, RN, MAN, MAEd, PhD
. . a. ) PRC No.: 0077182 .
Valid Until: November 22, 2010 Valid Until: October 31, 2011 . a.) PRC No.: 0053722
. . Valid Until: December 10, 2010 .
b.) PNA No.: 066620 b.) PNA No.: 19685 . Valid Until: August 31, 2012
. . b.) PNA No.: 80212 .
Valid Until: December 31, 2009 Valid Until: Lifetime . b.) PNA No.: 11836
. . Valid Until: December 31, 2009 .
c.) ANSAP No.: 02507 . Valid Until: Lifetime
. .
Valid Until: December 31, 2009 c.) ADPCN No.: 0063
. .
Valid Until: October 31, 2010
.

XAVIER UNIVERSITY – ATENEO DE CAGAYAN

Corrales Avenue, Cagayan de Oro City, Philippines
School Code: 0839

Name of Student: PAULA HELENA ROJAS ABA

Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City
Accreditation level: (If any) None Year Granted: Not Applicable
Date School / Program was Recognized: June 9 Number: 008 Year: 1992
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: 2005
Year Graduated (BSN Program): 2009

I. MAJOR OPERATIONS
Date of Case Signature of
Num Name of Type of Name of Name of Name of Operating
Operati Numbe Diagnosis Operation Performed Operating Room
ber Patient Anesthesia Surgeon Hospital Room Scrub Nurse
on r Scrub Nurse
Cholelithiasis with Spinal Northern
Decembe
Gina cholecystolithiasis, Cholecystectomy Anesthesia – Dr. Elmer Mindanao Pilarlita Mae S. Pagaray,
1 r 19, 480465
Dagunot gangrenous gallbladder Lavage and Drainage Epidural Zalsos Medical BSN, RN
2007
with adhesion Anesthesia Center
Northern
Decembe Nodular Non-toxic goiter Total Thyroidectomy
Francisco General Dr. Bernabe Mindanao Pilarlita Mae S. Pagaray,
2 r 20, 352552 with neck metastasis with Radical Neck
Canaya Anesthesia Mendoza Medical BSN, RN
2007 probably malignant Dissection, Right
Center
 Healed Fracture Radius Removal of Implant Northern
Dr. Justiniano
April 24, Middle Third, Right; Re- Radius, Right; Re- General Mindanao Leni I. Gestuveo, BSN,
3 507532 Eddie Yap Aquilino Cyril
2008 fracture Medial Third Ulna, plating of the medial Anesthesia Medical RN
Pimentel
Right third ulna, Right Center
Northern
April 24, Leonila Simple Mastectomy, General Dr. Riman Mindanao Almer Jan L. Zalsos, BSN,
4 507732 Phylloides Tumor, Left
2008 Villaruel Left Anesthesia Ricardo Medical RN
Center

Gingoog
April 23, Clemente Incarcerated Inguinal Local Dr. Joel
5 006679 Herniorrhapy, Right District Fe T. Teope, BSN, RN
2009 Salarda Hernia Anesthesia Babanto
Hospital

Prepared by: Supervised by: Noted by: Concurred by: Concurred by: Approved by:

PAULA HELENA ROJAS ___MRS. IVY R. GO_ MRS.CHRISTY G. DABLO DR. DOROTHEA N. MRS. JULIANA L. JAVIER DR. RAMONA HEIDI C.
ABA__ __ . ROQUE . . PALAD .
Name of Clinical Instructor Clinical Coordinator Chief Nurse Chief Nurse Dean College of Nursing
Student Date Signed: Date Signed: Northern Mindanao Gingoog District Hospital Xavier University-Ateneo de
_________________________________ Medical Center Date Signed: Cagayan
__ . Date Signed: Date Signed:
Degree:BSN, RN, MAN Degree: BSN, RN, MN, MAN
.
. .
. Degree: BSN, RN, Degree: BSN, RN .
a.) PRC No.: 0222293 a.) PRC No.: 0222342
MAN, Ed D. . . Degree: BSN, RN, MAN,
. .
a.) PRC No.: 0041397 a. ) PRC No.: 0077182 MAEd, PhD .
Valid Until: April 21, 2010 Valid Until: November 22,
. . a.) PRC No.: 0053722
. 2010 .
Valid Until: February 6, 2010 Valid Until: December 10, .
b.) PNA No.: 066616 b.) PNA No.: 066620
. b.) 2010 . Valid Until: August 31,
. .
PNA No.: 018604 b.) PNA No.: 80212 2012 .
Valid Until: December 31, 2009 Valid Until: December 31,
. . b.) PNA No.: 11836
. 2009 .
Valid Until: December 31, Valid Until: December 31, .
2009 . 2009 . Valid Until: Lifetime
c.) ANSAP No.: 05047 .
. Valid c.) ADPCN No.: 0063
Until: December 31, 2009 .
. Valid Until: October 31,
2010 .
 XAVIER UNIVERSITY – ATENEO DE CAGAYAN
Corrales Avenue, Cagayan de Oro City, Philippines
School Code: 0839

Name of Student: PAULA HELENA ROJAS ABA

Name & Address of School: Xavier University – Ateneo de Cagayan, Corrales Avenue, Cagayan de Oro City
Accreditation level: (If any) None Year Granted: Not Applicable
Date School / Program was Recognized: June 9 Number: 008 Year: 1992
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: 2005
Year Graduated (BSN Program): 2009

II. MINOR OPERATIONS

Date of Case Signature of
Num Name of Type of Name of Name of Name of Operating
Operati Numbe Diagnosis Operation Performed Operating Room
ber Patient Anesthesia Surgeon Hospital Room Scrub Nurse
on r Scrub Nurse
Northern
Decembe Excision of
Hazel Jane General Dr. Dures Fe Mindanao Joesphine U. Cabeguin,
1 r 19, 480457 Sacrococcygeal Mass Sacrococcygeal
Malinay Anesthesia Tagayuna Medical BSN, RN
2007 Teratoma
Center
Mother’s
House, Xavier
Dr. Maria
February 2008- Nilda Local University – Grace L. Llevares, BSN,
2 Multiparity Bilateral Tubal Ligation Corazon
8, 2008 601 Adoremos Anesthesia Community RN
Cuaycong
Health Care
Center
Mother’s
House, Xavier
Dr. Maria
March 2008- Judith Local University – Grace L. Llevares, BSN,
3 Multiparity Bilateral Tubal Ligation Corazon
19, 2008 615 Baterna Anesthesia Community RN
Cuaycong
Health Care
Center

City Health
April 17, Howard Local Dr. Melodee
4 259 Phimosis Circumcision Office -Tablon Iryn L. Salcedo, BSN, RN
2008 Wyne Llesis Anesthesia Zamora
Health Center

City Health
April 17, Howard Local Dr. Melodee
5 260 Phimosis Circumcision Office -Tablon Iryn L. Salcedo, BSN, RN
2008 Miles Llesis Anesthesia Zamora
Health Center
Prepared by: Supervised by: Noted by: Concurred by: Concurred by: Concurred by: Approved by:

PAULA HELENA ROJAS MRS. IVY R. GO ___ MRS.CHRISTY G. _ __DR. DOROTHEA N. __ MRS. EVA R. ______MS. IRYN L. ____DR. RAMONA HEIDI C.
ABA____ ___ DABLO_____ ROQUE_____ LLENO________ SALCEDO______ PALAD___
Name of Student Clinical Instructor Clinical Coordinator Chief Nurse Chief Nurse Public Health Nurse III Dean College of Nursing
Date Signed: Date Signed: Northern Mindanao Xavier University – City Health Office Xavier University-Ateneo de
Medical Center Community Health Care Date Signed: Cagayan
. Date Signed: Center Date Signed:
Degree: BSN, RN, MAN . Date Signed:
. Degree: BSN, RN, MN, MAN . .
a.) PRC No.: 0222293 . Degree: BSN, RN, MAN, Ed D. . Degree: BSN, RN, MPH .
. a.) PRC No.: 0222342 . a.) PRC No.: Degree: BSN, RN, MHA . Degree: BSN, RN, MAN, MAEd,
Valid Until: April 21, 2010 . 0041397 . . a.) PRC No.: 0148109 PhD .
. Valid Until: November 22, Valid Until: February 6, a. ) PRC No.: 0091662 . a.) PRC No.: 0053722
b.) PNA No.:066616 2010 . 2010 . b.) . Valid Until: January 11, .
. b.) PNA No.: 066620 PNA No.: 018604 Valid Until: August 9, 2012 2012 . Valid Until: August 31, 2012
Valid Until: December 31, . . . b.) PNA No.: 79897 .
2009 . Valid Until: December 31, Valid Until: December 31, b.) PNA No.: 18586 . b.) PNA No.: 11836
2009 . 2009 . . Valid Until: December 31, .
c.) ANSAP No.: 05047 Valid Until: Lifetime 2009 . Valid Until: Lifetime
. . .
Valid Until: December 31, c.) ANSAP No.: 090011 c.) ADPCN No.: 0063
2009 . . .
Valid Until: Lifetime Valid Until: October 31,
. 2010 .