ILIGAN MEDICAL CENTER COLLEGE

College of Nursing and Midwifery ODC FORM 2A

San Miguel Village, Pala-o Iligan City 9200
O.R. SCRUB
Telephone No. (063) 221-4661 Local 1120
Fax No. (063) 221-6584 FORM
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023

I. MAJOR OPERATIONS

No. Date of Operation Case No. Name of Patient Diagnosis Operation Performed Type of Name of Name of Hospital O.R. Nurse on Duty Supervised by:
Anesthesia Surgeon (Name and Signature of
Qualified C.I.)

Menchela Y. Gravida 3 Para 2 (3002) Pregnancy Repeat Cesarean Section with Spinal Dr. Joan Gregorio T. Lluch Joel B. Montejo, RN Joel T. Ablin, RN, MN
1. December 17, 2021 467974 Rodrigues Uterine 38-week Age of Gestation Bilateral Tubal Ligation Anesthesia Claire S. Memorial Hospital PRC No. 0331057 PRC No. 0296985
Cesarean not in Labor Previous Flores
Cesarean Section
General
2. June 13, 2022 488419 Myrna S. Daque Papillary Breast Cancer Stage 3 Modified Radical Anesthesia Dr. Amina Gregorio T. Lluch Maureen Anne P. Gorospe, RN Joel T. Ablin, RN, MN
Mastectomy(Right) Rasul Memorial Hospital PRC No. 0710003 PRC No. 0296985

3. June 21, 2022 490431 Rolando O. Neglected Shoulder Dislocation Open Reduction Right Shoulder General Dr. Richillo Gregorio T. Lluch Kissa S. Magsayo, RN Joel T. Ablin, RN, MN
Tusloc (Right) With Glenohumeral Pinning Anesthesia Daguman Memorial Hospital PRC No. 0930118 PRC No. 0296985

4. August 16, 2022 422375 Amelita S. Pelvic Organ Prolapsed Stage 3 Vaginal Hysterectomy With Anterior Spinal Dr. Batawi Gregorio T. Lluch Rubenymph R Lawas, RN Joel T. Ablin, RN, MN
Aragones Colporrhaphy Anesthesia Memorial Hospital PRC No. 0367947 PRC No. 0296985

Rudelio L. Osteotomy+Open Reduction and Spinal Dr. Richillo Gregorio T. Lluch Gean Paolo S. Kuan, RN Joel T. Ablin, RN, MN
5. August 18, 2022 490495 Tanghian Malunion Tibia (Left) Internal Fixation (OORIF) Anesthesia Daguman Memorial Hospital PRC No.0714471 PRC No. 0296985
Intramedullary Nailing

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature over Printed Name of Dean
Date Signed: ___________________ Date Signed: ___________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023
 ILIGAN MEDICAL CENTER COLLEGE
ODC FORM 2B
College of Nursing and Midwifery
San Miguel Village, Pala-o Iligan City 9200 O.R. CIRCULATING
Telephone No. (063) 221-4661 Local 1120 FORM
Fax No. (063) 221-6584
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023
II. CIRCULATING OPERATIONS

No. Date of Operation Case No. Name of Patient Diagnosis Operation Performed Type of Name of Name of Hospital O.R. Nurse on Duty Supervised by:
Anesthesia Surgeon (Name and Signature of
Qualified C.I.)

1. December 13, 2021 459644 Janilyn M. Lateral Neck Mass Modified Radical Neck Dissection General Dr. Yu Gregorio T. Lluch Vincent Ralfh M. Paclipan, RN Joel T. Ablin, RN, MN
Bagamaspad Endotracheal Memorial Hospital PRC No. 0783030 PRC No. 0296985
Anesthesia

2. December 16, 2021 323806 Jinalyn R. Gravida 2 Para 2 (2002) Adenomyosis Total Abdominal Hysterectomy Spinal Dr.Abedin Gregorio T. Lluch Joel B. Montejo, RN Joel T. Ablin, RN, MN
Macapanton with Bilateral Salpingo- Anesthesia Memorial Hospital PRC No. 0331057 PRC No. 0296985
oophorectomy

3. June 13, 2022 488437 Juliet Realse ORIF-Plate Materal Malleolus (Left) Fracture Closed Complete Spinal Dr. Richillo Gregorio T. Lluch Gean Paolo S. Kuan, RN Joel T. Ablin, RN, MN
ORIF-Screw (Lag) Medial Malleolus (Left) Displaced Bimalleolar (Left) Anesthesia Dagunan Memorial Hospital PRC No.0714471 PRC No. 0296985

4. August 15, 2022 380708 Mila L. Malunion Distal Radius (Right) Osteotomy+Open Reduction and General Dr. Richillo Gregorio T. Lluch Gean Paolo S. Kuan, RN Joel T. Ablin, RN, MN
Temporada Internal Fixation (OORIF)-Locked Anesthesia Dagunan Memorial Hospital PRC No.0714471 PRC No. 0296985
Plate Distal Radius (Right)

Laurine C. Gravida 2 Para 1 (2001) Pregnancy Uterine 39 Repeat Cesarean Section Spinal Dr. Flores Gregorio T. Lluch Vincent Ralfh M. Paclipan, RN Joel T. Ablin, RN, MN
5. August 24, 2022 449204 Ceballos Weeks Age of Gestation Cephalic Presentation Anesthesia Memorial Hospital PRC No. 0783030 PRC No. 0296985
Previous Cesarean Section 1 Time

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature Over Printed Name of Dean
Date Signed: ___________________ Date Signed: _________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a.) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023
 ILIGAN MEDICAL CENTER COLLEGE
College of Nursing and Midwifery ODC FORM 2C
San Miguel Village, Pala-o Iligan City 9200 O.R. Scrub Minor
Telephone No. (063) 221-4661 Local 1120
FORM
Fax No. (063) 221-6584
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023

III. MINOR OPERATIONS

No. Date of Operation Case No. Name of Diagnosis Operation Performed Type of Name of Name of Hospital O.R. Nurse On Duty Supervised by:
Patient Anesthesia Surgeon (Name and Signature of
Qualified C.I.)

Abnormal Uterine Bleeding Vaginal Myomectomy Spinal Dr. Abedin Gregorio T. Lluch Florabel C.Clavano, RN Joel T. Ablin, RN, MN
1. December 14,2021 476961 Tissle G. Tinoy Secondary to Submucous Myoma Diagnostic Curettage Anesthesia Memorial Hospital PRC No. 0271495 PRC No. 0296985
Anemia Secondary to Acute Blood
Loss
Gravida 7 Para 7 (7007) Spinal
2. June 21, 2022 487873 Mary Jane A. Grandmultiparity Postpartum Bilateral Tubal Anesthesia Dr. Batawi Gregorio T. Lluch Vincent Ralfh M. Paclipan, RN Joel T. Ablin, RN, MN
Angelo Ligation Memorial Hospital PRC No. 0783030 PRC No. 0296985

Gravida 1 Para 1 (1001) Pregnancy Episiorraphy Local Dr. Flores Gregorio T. Lluch Sweet G. Bagsican,RM,RN Joel T. Ablin, RN, MN
3. June 29, 2022 488665 Jefel C.Kilat Uterine 39 6/7 Weeks Age of Anesthesia Memorial Hospital PRC No. 0618669 PRC No. 0296985
Gestation By Last Menstrual Period,
Cephalic, in Labor

4. August 22, 2022 464562 Teodosia P. Lacerated TongueAnterior 1/3 More Repair Laceration of Tongue, Local Dr. Yu Gregorio T. Lluch Mizpah Rebekah T. Sogo-an, RN Joel T. Ablin, RN, MN
Jarada Total 5cm Floor of Mouth-25cm Anesthesia Memorial Hospital PRC No. 0913563 PRC No. 0296985

5. August 23, 2022 489572 Emeliana P. Postmenopausal Bleeding Probably to Endometrial Curettage Spinal Dr. Batawi Gregorio T. Lluch Vincent Ralfh M. Paclipan, RN Joel T. Ablin, RN, MN
Pacana Endometrial Phatology Anesthesia Memorial Hospital PRC No. 0783030 PRC No. 0296985

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature Over Printed Name of Dean
Date Signed: ___________________ Date Signed: _________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a.) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023
 ILIGAN MEDICAL CENTER COLLEGE ODC FORM 1A
College of Nursing and Midwifery
ACTUAL DELIVERY
San Miguel Village, Pala-o Iligan City 9200
Telephone No. (063) 221-4661 Local 1120 FORM
Fax No. (063) 221-6584
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023
IV. HANDLED DELIVERY

No. Case Diagnosis Name of Age Date of Time of Gender Name of Type of Delivery D.R Nurse On Duty Supervised by:
Number Mother Delivery Delivery of Baby Hospital (Name & Signature of Qualified
C.I.)

1 488890 Gravida 1 Para 1, Pregnancy Sweety Millanar 24 June 6, 2022 10:00 Female Gregorio T. Normal Sweet G. Bagsican,RM, RN Marlyn A.Obedencio RN, MN, MN
Uterine, Full Term am LLuch Memorial Spontaneous PRC No. 0913736 PRC No. 0302519
Vaginal Delivery
Hospital

2 484113 Gravida 1 Para 1, Pregnancy Jackilyn Samson 22 June 27,2022 1:23 pm Male Gregorio T. Normal Lezelda A. Conde, RN Glenda T.Venus, RN, MN
Uterine, Full Term LLuch Memorial Spontaneous PRC No. 0881458 PRC No. 0318385
Vaginal Delivery
Hospital

3 488665 Gravida 1 Para 1, Pregnancy Jefel C. Kilat 27 June 29,2022 6:53 am Male Gregorio T. Normal Lezelda A. Conde, RN Glenda T.Venus, RN, MN
Uterine, Full Term LLuch Memorial Spontaneous PRC No. 0881458 PRC No. 0318385
Vaginal Delivery
Hospital

4 483264 Gravida 2 Para 2, Pregnancy Mary Queen 25 July 1, 2022 1:52 pm Male Gregorio T. Normal Sweet G. Bagsican,RM, RN Glenda T.Venus, RN, MN
Uterine, Full Term M. Amantiad LLuch Memorial Spontaneous PRC No. 0913736 PRC No. 0318385
Vaginal Delivery
Hospital

5 498275 Gravida 1 Para 1, Pregnancy Shalyn C. 20 September 1:50 pm Male Gregorio T. Normal Liberty N.Pabillaran, RN, MN Glenda T.Venus, RN, MN
Imperial 6,2022 LLuch Memorial Spontaneous PRC No. 0170140 PRC No. 0318385
Uterine, Full Term
Vaginal Delivery
Hospital

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature over Printed Name of Dean
Date Signed: ___________________ Date Signed: _________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a.) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023
 ILIGAN MEDICAL CENTER COLLEGE
College of Nursing and Midwifery
ODC FORM 1B
San Miguel Village, Pala-o Iligan City 9200
Telephone No. (063) 221-4661 Local 1120 ASSISTED DELIVERY
Fax No. (063) 221-6584 FORM
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023
V. ASSISTED DELIVERY

No. Case Diagnosis Name of Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery D.R Nurse On Duty Supervised by:
Number Mother Delivery Baby (Name & Signature of Qualified C.I)

1 423007 Gravida 5 Para 4, Pregnancy Rheniza Mae 22 June 9, 2022 7:41 am Female Gregorio T. LLuch Normal Sweet G. Bagsican,RM, RN Marlyn A.Obedencio RN, MN, MN
Uterine, Full Term Malubay Memorial Hospital Spontaneous PRC No. 0913736 PRC No. 0302519
Vaginal Delivery

2 487651 Gravida 3 Para 3, Pregnancy Lady Gems 28 June 28, 2022 10:50 am Female Gregorio T. LLuch Normal Lezelda A. Conde, RN Glenda T.Venus, RN, MN
Uterine, Full Term Ventuza Memorial Hospital Spontaneous PRC No. 0881458 PRC No. 0318385
Vaginal Delivery

3 492231 Gravida 6 Para 5, Pregnancy Aida C. 28 July 1, 2022 9:59 am Male Gregorio T. LLuch Normal Liberty N. Pabillaran, RN, MN Glenda T.Venus, RN, MN
Uterine, Full Term Dituculan Memorial Hospital Spontaneous PRC No. 0170140 PRC No. 0318385
Vaginal Delivery

4 498238 Gravida 3 Para 2, Pregnancy Cristy M. 31 September 7, 2022 12:46 pm Female Gregorio T. Normal Lezelda A. Conde, RN Glenda T.Venus, RN, MN
Uterine, Full Term Clapano LLuch Memorial Spontaneous PRC No. 0881458 PRC No. 0318385
Hospital Vaginal Delivery

5 415168 Gravida 4 Para 4, Pregnancy Luisa N. 37 September 20, 2:30 pm Male Gregorio T. LLuch Normal Liberty N. Pabillaran, RN, MN Glenda T.Venus, RN, MN
Uterine, Full Term Labor 2022 Memorial Hospital Spontaneous PRC No. 0170140 PRC No. 0318385
Vaginal Delivery

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature Over Printed Name of Dean
Date Signed: ___________________ Date Signed: _________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a.) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023
 ILIGAN MEDICAL CENTER COLLEGE
College of Nursing and Midwifery ODC FORM 1C
San Miguel Village, Pala-o Iligan City 9200 CORD CARE
Telephone No. (063) 221-4661 Local 1120 FORM
Fax No. (063) 221-6584
Website: www.imcc.edu.ph

Name of Student: Amera I. Gumama

Accreditation Level: PACUCOA Level II Third Reaccredited Year Granted: 2006 - Valid Until 2023
Date School/ Program were Recognized: June 17, 1985
First Course: (if any): Not Applicable
Year of Admission in Bachelor of Science in Nursing: 2015
Year Graduated (BSN Program): May 2023

VI. CORD DRESSING

No. Case Diagnosis Name of Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery D.R Nurse on Duty Supervised by:
Number Mother Delivery Baby (Name & Signature of Qualified C.I)

1 489996 Live, Term Neonate Apgar Score Jeralin Balag 29 June 9, 2022 10:18 Male Gregorio T. LLuch Normal Adella L. Lom-oc, RN Marlyn A.Obedencio RN, MN, MN
8,9, Birth Weight 3.06 kg am Memorial Hospital Spontaneous PRC No. 0885404 PRC No. 0302519
Vaginal
Delivery

2 491144 Live, Term, Neonate Apgar Score Cherry Mae 19 June 28, 2022 7:30 am Female Gregorio T. LLuch Normal Roygi Lizette E. Tubo- Daing, RN Glenda T.Venus, RN, MN
Pil Memorial Hospital Spontaneous PRC No. 0847027 PRC No. 0318385
8,9, Birth Weight 3.02 kg
Vaginal
Delivery

3 491164 Live, Term, Neonate Apgar Score Edlyn 32 June 29, 2022 12:31 pm Female Gregorio T. LLuch Normal Hyacinthe Laborada Usog RN, Glenda T.Venus, RN, MN
8,9, Birth Weight 3.05 kg Paculba am Memorial Hospital Spontaneous PRC No. 0923072 PRC No. 0318385
Vaginal
Delivery

4 491721 Live, Term, Neonate Apgar Score Jezel Mae 31 June 30, 2022 1:35 am Male Gregorio T. LLuch Normal Geraldine B. Tabora, RN Glenda T.Venus, RN, MN
8,9, Birth Weight 2.88 kg Grementer Memorial Hospital Spontaneous PRC No. 0837712 PRC No. 0318385
Vaginal
Delivery

5 498714 Live, Term, Neonate Apgar Score Gretchen 28 September 05, 9:26 am Female Gregorio T. LLuch Normal , Bea Jane R. Ginco, RN Glenda T.Venus, RN, MN
8,9, Birth Weight 3.36 kg Diolola 2022 Memorial Hospital Spontaneous PRC No. 0774596 PRC No. 0318385
Vaginal
Delivery

Prepared By: Noted By: Approved By:

AMERA I. GUMAMA CHARLIE C. PLAZA, RN, MAN ELIZABETH L. ALAGAR, RN, MAN
Signature over Printed Name Clinical Coordinator Signature Over Printed Name of Dean
Date Signed: ___________________ Date Signed: _________________
Degree: BSN, RN, MAN Degree: BSN, RN, MAN
a.) PRC No.: 0182453 a.) PRC No.: 0089156
Valid Until: November 2023 Valid Until: June 18, 2026
b.) PNA No.: 16813 b.) PNA No.: 14137
Valid Until: Lifetime Valid Until: Lifetime
c.) ADCPN No.: 125
Valid Until: December 21, 2023