UNIVERSITY OF PANGASINAN

Phinma Education Network

COLLEGE OF NURSING
Dagupan City
University Seal
CLINICAL ROTATION

Name: EVANGELISTA, Kim Jovellanos

Date Started in BSN Program: June 2007
Date Graduated From BSN Program: 2011

DEPARTMENT or Supervised by:

COURSE
YEAR MONTH HOSPITAL AREA of NAME of CLINICAL
NO.
ASSIGNMENT INSTRUCTOR

Nursing Classroom Instruction

Health Care I 2008 June - October Mrs. Ethel Q. Fernandez
Laboratory (Return Demonstration)
Barangay Salisay,
Health Care II 2008-2009 November - March CHN Mrs. Lourdes C. Salvador
Dagupan City
NCM 101 2009 June PHN Bonuan 1 Mrs. Jenny O. Peralta
2009 July R1MC Surgical Ward Mr. Kenneth C. Camacho
Ms. Ysabel Kristy L.
2009 August MMH General Ward
Cortez
Obstetric & Surgical Mr. Carlo Emmanuel E.
2009 September PMC
Ward Umali
NCM 102 2009 November WPDH Medical Ward Ms. Gee Lou C. Tibayan
Mrs Shirley Corazon C.
2010 January PHN RHU I-Calasiao
Vergara
Mr. Keithley Roel C.
2010 February PPH Pediatric Ward
Campo
NCM 103 2010 November NCMH Pavilion 1 Mrs. Juliet A. Pineda
Emergency, Delivery &
2010 March - April BDH Mr. Bryan B.Junio
Operating Room
2010 April POC General Ward Mrs. Ofelia P. Bagasbas
2010 April SLH Pediatric Ward Mrs. Rufina Singian
Out-Patient Department Mrs. Maria Clara G.
2010 May WPDH
& Operating Room Sison
Emergency & Delivery
NCM 104 2010 June RHU-RCLC Mr. Dejay E. Paras
Room
Emergency, Delivery & Ms. Sharmaine Joy S.
2010 July PCFMI
Operating Room Quinto
Emergency, Delivery &
Operating Room;
Ms. Vanessa Joy S.
2010 August JNGH Intensive Care Unit &
Zabala
Neonatal Intensive Care
Unit
Emergency, Delivery &
2010 September ManCH Mr. Limuel G. Amansec
Operating Room
Emergency, Delivery &
2010 October CHI Mrs. Fredelyn D. Tullao
Operating Room
Delivery Room &
Ms. Cristina C. Vidal &
NCM 105 2010 November TPH Neonatal Intensive Care
Ms. Gee Lou C. Tibayan
Unit
2010 December CDVMH Delivery Room Mr. Orlando S. Pascua
2011 January PPH Delivery Room Mrs. Fredelyn D. Tullao
2011 February
2011 March
Prepared by:

KIM J. EVANGELISTA
Student Signature

AFFILIATING HOSPITALS/AGENCIES

LEGEND:
TERTIARY
BFDGH - Blessed Family Doctors General Hospital, San Carlos City, Pangasinan
EGH - Elguira General Hospital, San Carlos City, Pangasinan
JNGH - Jesus Nazarene General Hospital, Lingayen, Pangasinan
MCD - Medical Centrum Dagupan, Dagupan City, Pangasinan
PCFMI - Pangasinan Center for Family Medicine, Incorporated, Dagupan City, Pangasinan
PDH - Pangasinan Doctors Hospital, San Carlos City, Pangasinan
PMC - Pangasinan Medical Center, Dagupan City, Pangasinan (BASE HOSPITAL)
PPH - Pangasinan Provincial Hospital, San Carlos City, Pangasinan
R1MC - Region 1 Medical Center, Dagupan City, Pangasinan (BASE HOSPITAL)
TPH - Tarlac Provincial Hospital, Tarlac City, Tarlac

SECONDARY
BDH - Bayambang District Hospital, Bayambang, Pangasinan
CHI - Cuison Hospital Incorporated, Dagupan City, Pangasinan
WPDH - Western Pangasinan District Hospital, Alaminos City Pangasinan
DMMCMH - Dr. Marcelo M. Chan Memorial Hospital, Carmen, Rosales, Pangasinan

PRIMARY
CDVMH - Col. Domingo Valdez Memorial Hospital, Dasol, Pangasinan
CHO, DC - City Health Office, Dagupan City, Pangasinan
DLMLC - Dr. De Leon Maternity and Lying-in Clinic, Alaminos City, Pangasinan
DMCH - Decena Medical Clinic and Hospital, Dagupan City, Pangasinan
LDH - Lingayen District Hospital, Lingayen, Pangasinan (formerly DMCVMH)
LCH - Labrador Community Hospital, Labrador, Pangasinan
ManCH - Manaoag Community Hospital, Manaoag, Pangasinan
MapCH - Mapandan Comuunity Hospital, Mapandan, Pangasinan
MCHP - Missionaries of Charity Home of Peace, Dagupan City, Pangasinan
MMH - Malasiqui Municipal Hospital, Malasiqui, Pangasinan
RHU-RCLC - Rural Health Unit – Rosales Community and Lying-in Clinic, Rosales, Pangasinan
RHU - Rural Health Unit I and II – Calasiao, Pangasinan
- Rural Health Unit I – Binmaley, Pangasinan
- Rural Health Unit I – Lingayen, Pangasinan
- Rural Health Unit I – Malasiqui, Pangasinan
- Rural Health Unit I – Manaoag, Pangasinan
- Rural Health Unit I – Mangaldan, Pangasinan
- Rural Health Unit I – Mapandan, Pangasinan

SPECIAL HOSPITALS
DJNRMH - Dr. Jose N. Rodriguez Memorial Hospital, Tala, Caloocan City
NCMH - National Center for Mental Health, Mandaluyong City
POC - Philippine Orthopedic Center, Banawe St., Quezon City
SLH - San Lazaro Hospital, Sta. Cruz, Manila

*DMCVMH - Don Mariano C. Versoza Memorial Hospital, Lingayen, Pangasinan

Noted by: Approved by:

ZENAIDA M. BAUTISTA MARIA TERESA R. FAJARDO

Clinical Coordinator Dean

Date Signed: Date Signed:

Degree: B.S.N., R.N., M.A.N. Degree: B.S.N., R.N., M.A.N.
a) PRC No.: 0133422 Valid Until:July 27, 2011 a) PRC No.: 0160104 Valid Until: September 09. 2013
b) PNA No.: 040412 Valid Until:October 31, 2011 b) PNA No.: 040351 Valid Until: October 31, 2011
c) ADPCN No.: 19482 Valid Until: May 2011