UNCIANO COLLEGES, INC.

Circumferential Road, Antipolo City

I. MAJOR OPERATIONS

No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of Qualified Signature of Qualified Clinical
Operation Anesthesia Clinical Instructor Instructor

1 August 25, 2010 0049285 Trix Mariell Mariñas Pregnancy Uterine Full Term Caesarian Spinal Lourdes Simeon, MD Unciano Medical Center Irene D. Soriano, RN Irene D. Soriano, RN
Cephalic in Labor Arest in PRC #: PNA#:
Cervical Dilitation Gravida 1 Validity: Validity:
Para 0 Date Signed

2 January 27, 2011 0050207 Karl Llave Avulsed Wound Left Temporo- Craniectomy Spinal Renan Acosta, MD Unciano Medical Center Lina C. Cinco, RN Lina C. Cinco, RN
Paraietal Open PRC #: PNA#:
Validity: Validity:
Date Signed:

3 Spinal
PRC #: PNA#:
Validity: Validity:
Date Signed:

4 Spinal PRC #: PNA#:

Validity: Validity:
Date Signed

5 Spinal
PRC #: PNA#:
Validity: Validity:
Date Signed

Prepared by:

Name of student: Hanzel H. Ana

Name & Address of School: Unciano Colleges Inc. Circumferential Road Brgy. San Roque Antipolo City
Date School/Program was recognized: GR (R-IV) Number 004 S. 1992
First Course (if any): None
Year of Admission in the Bachelor of Science in Nursing Program: June 2007
Year Graduated (BSN Program): April 15, 2011

Noted by: Concurred by: Concurred by: Approved by:

Signature over Printed name of Signature over Printed name of Signature over Printed name of Signature over Printed name Signature over Printed name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Designated Signatory Unciano Colleges, Inc. Antipolo City
Unciano Colleges, Inc. Antipolo City Unciano Medical Center Garcia General Hospital Date Signed:____________ Date Signed: ______________
Date Signed: __________ Date Signed: __________ Date Signed: _________ Unciano Colleges, Inc. Antipolo City Degree:
Degree: Degree: Degree: Degree: a) PRC#:
a) PRC#: a) PRC#: a) PRC#: a) PRC#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: b) PNA#:
b) PNA#: b) PNA#: b) PNA#: b) PNA#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: c) ADPCN#:
c) ADPCN#: Valid Until:
Valid Until:

Prepared by: HANZEL H. ANA

Signature over printed name
 UNCIANO COLLEGES, INC.
Circumferential Road, Antipolo City

II. MINOR OPERATIONS

No. Date of Case No. Name of Patient Diagnosis Operation Performed Type of Name of Surgeon Name of Hospital Name of Qualified Signature of Qualified Clinical Instructor
Operation Anesthesia Clinical Instructor

1 January 20, 2011 0050188 Cristine Aira Ortile Left Breast Mass Excision Biopsy Left Breast Local Herminio Unciano Medical , Lina C. Cinco, RN Lina C. Cinco, RN
Mass Hernandez, MD Center PRC #: PNA#:
Validity: Validity:
Date Signed;

2 January 22, 2011 0100499 Paulino Caramat Jr. Chronic Kidney Disease Intrajugular Catheter Local Isidro Medoza, MD Unciano Medical Lina C. Cinco, RN Lina C. Cinco, RN
Secondary to Diabetes Mellitus Insertion Center PRC #: PNA#:
Nepropathy Validity: Validity:
Date Signed:

3
PRC #: PNA#:
Validity: Validity:
Date Signed:

4
PRC #: PNA#:
Validity: Validity:
Date Signed:

5
PRC #: PNA#:
Validity: Validity:
Date Signed:

Prepared by:

Name of student: Hanzel H. Ana

Name & Address of School: Unciano Colleges Inc. Circumferential Road Brgy. San Roque Antipolo City
Date School/Program was recognized: GR (R-IV) Number 004 S. 1992
First Course (if any): None
Year of Admission in the Bachelor of Science in Nursing Program: June 2007
Year Graduated (BSN Program): April 15, 2011

Noted by: Concurred by: Concurred by: Approved by:

Signature over Printed name of Signature over Printed name of Signature over Printed name of Signature over Printed name Signature over Printed name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Designated Signatory Unciano Colleges, Inc. Antipolo City
Unciano Colleges, Inc. Antipolo City Unciano Medical Center Garcia General Hospital Date Signed:____________ Date Signed: ______________
Date Signed: __________ Date Signed: __________ Date Signed: _________ Unciano Colleges, Inc. Antipolo City Degree:
Degree: Degree: Degree: Degree: a) PRC#:
a) PRC#: a) PRC#: a) PRC#: a) PRC#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: b) PNA#:
b) PNA#: b) PNA#: b) PNA#: b) PNA#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: c) ADPCN#:
c) ADPCN#: Valid Until:
Valid Until:

Prepared by: HANZEL H. ANA

Signature over printed name
 UNCIANO COLLEGES, INC.
Circumferential Road, Antipolo City

III. ACTUAL DELIVERIES

No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Supervised by Name & Signature of
Delivery Baby Qualified C.I.
Ma. Teresita F. Cerapion RN, MAN
1 Pregnancy Uterine Gravida 6
541701 Para 5 40 to 42 weeks Age of Teresita Gonzaga 40 August 1, 2010 10:55 pm Female Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Ma. Teresita F. Cerapion RN, MAN

2 541772 Pregnancy Uterine Gravida 1
Para 0 40 to 41 weeks Age of Jennilyn Castro 27 August 3, 2010 1:10 am Fermale Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Ma. Teresita F. Cerapion RN, MAN

3 541826 Pregnancy Uterine Gravida 2
Para 1 37 weeks Age of Elizabeth Gutierez 27 3:05 am Male Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
August 4, 2010
Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Ma. Teresita F. Cerapion RN, MAN

4 542038 Pregnancy Uterine Gravida 1 Rizal Provincial Hospital
Para 0 39 to 40 weeks Age of Cristel Jane Reyes 19 2:25 am Female Normal Spontaneous PRC#: PNA#:
August 9, 2010
Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Ma. Luz L. Dieron, RM, RN, MAN

5 Pregnancy Uterine Gravida 1
Para 0 38 weeks Age of Antipolo District Hospital Normal Spontaneous PRC#: PNA#:
Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Prepared by:

Name of student: Hanzel H. Ana

Name & Address of School: Unciano Colleges Inc. Circumferential Road Brgy. San Roque Antipolo City
Date School/Program was recognized: GR (R-IV) Number 004 S. 1992
First Course (if any): None
Year of Admission in the Bachelor of Science in Nursing Program: June 2007
Year Graduated (BSN Program): April 15, 2011
Noted by: Concurred by: Concurred by: Approved by:

Signature over Printed name of Signature over Printed name of Signature over Printed name of Signature over Printed name Signature over Printed name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Designated Signatory Unciano Colleges, Inc. Antipolo City
Unciano Colleges, Inc. Antipolo City Unciano Medical Center Garcia General Hospital Date Signed:____________ Date Signed: ______________
Date Signed: __________ Date Signed: __________ Date Signed: _________ Unciano Colleges, Inc. Antipolo City Degree:
Degree: Degree: Degree: Degree: a) PRC#:
a) PRC#: a) PRC#: a) PRC#: a) PRC#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: b) PNA#:
b) PNA#: b) PNA#: b) PNA#: b) PNA#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: c) ADPCN#:
c) ADPCN#: Valid Until:
Valid Until:
Prepared by: HANZEL H. ANA
 Signature over printed name

UNCIANO COLLEGES, INC.

Circumferential Road, Antipolo City
IV. DELIVERIES ASSISSTED

No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Gender of Name of Hospital Type of Delivery Supervised by Name & Signature of
Delivery Baby Qualified C.I.
Ma. Teresita F. Cerapion RN, MAN
1 Pregnancy Uterine Full Term
541726 Gravida 2 Para 1 37 to 38 weeks Ma. Joynie Torres 30 August 2, 2010 5:22 am Female Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
Age of Gestation by Last Menstrual Delivery Validity: Validity:
Period, Cephalic in Labor Date Signed:

Ma. Teresita F. Cerapion RN, MAN

2 541790 Pregnancy Uterine Gravida 8
Para 7 38 to 39 weeks Age of Luningning Labrage 37 12:03 am Male Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
August 4, 2010 Validity: Validity:
Gestation by Last Menstrual Period, Delivery
Cephalic in Labor Date Signed:

Ma. Teresita F. Cerapion RN, MAN

3 542086 Pregnancy Uterine Gravida 2
Para 1 38 to 39 weeks Age of Mary Ann Monesta 25 2:33 am Female Rizal Provincial Hospital Normal Spontaneous PRC#: PNA#:
August 10, 2010
Gestation by Last Menstrual Period, Delivery Validity: Validity:
Cephalic in Labor Date Signed:

Ma. Luz L. Dieron, RM, RN, MAN

4
Antipolo District Hospital Normal Spontaneous PRC#: PNA#:
Delivery Validity: Validity:
Date Signed:

Ma. Luz L. Dieron, RM, RN, MAN

5
Antipolo District Hospital Normal Spontaneous PRC#: PNA#:
Delivery Validity: Validity:
Date Signed:

Prepared by:

Name of student: Hanzel H. Ana

Name & Address of School: Unciano Colleges Inc. Circumferential Road Brgy. San Roque Antipolo City
Date School/Program was recognized: GR (R-IV) Number 004 S. 1992
First Course (if any): None
Year of Admission in the Bachelor of Science in Nursing Program: June 2007
Year Graduated (BSN Program): April 15, 2011

Noted by: Concurred by: Concurred by: Approved by:

Signature over Printed name of Signature over Printed name of Signature over Printed name of Signature over Printed name Signature over Printed name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Designated Signatory Unciano Colleges, Inc. Antipolo City
Unciano Colleges, Inc. Antipolo City Unciano Medical Center Garcia General Hospital Date Signed:____________ Date Signed: ______________
Date Signed: __________ Date Signed: __________ Date Signed: _________ Unciano Colleges, Inc. Antipolo City Degree:
Degree: Degree: Degree: Degree: a) PRC#:
a) PRC#: a) PRC#: a) PRC#: a) PRC#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: b) PNA#:
b) PNA#: b) PNA#: b) PNA#: b) PNA#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: c) ADPCN#:
c) ADPCN#: Valid Until:
 Valid Until:

Prepared by: HANZEL H. ANA

Signature over printed name

UNCIANO COLLEGES, INC.

Circumferential Road, Antipolo City

V. CORD DRESSING

No. Case No. Date Performed Name of Baby Name of Mother Age Name of Hospital Supervised by: Name &
Signature of Qualified Clinical Instructor
Ma. Teresita F. Cerapion RN, MAN
1
541690 August 1, 2010 Baby Girl Alejo Jeanette Alejo 25 Soriano-Leyble Medical and PRC #: 0239206 PNA#: 009313
Maternity Hospital Validity: 10-29-12 Validity: 10-31-12
Date Signed:
Ma. Teresita F. Cerapion RN, MAN
2
541691 August 1, 2010 Baby Boy Lenida Jesusa Lenida 27 Soriano-Leyble Medical and PRC #: 0239206 PNA#: 009313
Maternity Hospital Validity: 10-29-12 Validity: 10-31-12
Date Signed:

3 Ma. Teresita F. Cerapion RN, MAN

541773 August 3, 2010 Baby Boy Cristobal Jessica Cristobal 18 Soriano-Leyble Medical and PRC#: 0239206 PNA#: 009313
Maternity Hospital Validity: : 10-29-12 Validity: 10-31-12
Date Signed:

Ma. Teresita F. Cerapion RN, MAN

4 19
541879 August 5, 2010 Baby Girl Parales Aileen Parales Soriano-Leyble Medical and PRC #: 0239206 PNA#: 009313
Maternity Hospital Validity: 10-29-12 Validity: 10-31-12
Date Signed:
Ma. Teresita F. Cerapion RN, MAN
5
0020733 August 23, 2010 Baby Girl Alvaran Luzviminda Alvaran 41 Shiphrah Birthing Home PRC #: 0013255 PNA#: 37330
Validity: 08-11-09 Validity: 03-11-10
Date Signed:

Prepared by:

Name of student: Hanzel H. Ana

Name & Address of School: Unciano Colleges Inc. Circumferential Road Brgy. San Roque Antipolo City
Date School/Program was recognized: GR (R-IV) Number 004 S. 1992
First Course (if any): None
Year of Admission in the Bachelor of Science in Nursing Program: June 2007
Year Graduated (BSN Program): April 15, 2011

Noted by: Concurred by: Concurred by: Approved by:

Signature over Printed name of Signature over Printed name of Signature over Printed name of Signature over Printed name Signature over Printed name of Dean
Clinical Coordinator Chief Nurse Chief Nurse Designated Signatory Unciano Colleges, Inc. Antipolo City
Unciano Colleges, Inc. Antipolo City Unciano Medical Center Garcia General Hospital Date Signed:____________ Date Signed: ______________
Date Signed: __________ Date Signed: __________ Date Signed: _________ Unciano Colleges, Inc. Antipolo City Degree:
Degree: Degree: Degree: Degree: a) PRC#:
a) PRC#: a) PRC#: a) PRC#: a) PRC#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: b) PNA#:
b) PNA#: b) PNA#: b) PNA#: b) PNA#: Valid Until:
Valid Until: Valid Until: Valid Until: Valid Until: c) ADPCN#:
c) ADPCN#: Valid Until:
Valid Until:
Prepared by: HANZEL H. ANA
Signature over printed name
Ma’am Cerapion PNA2011-046480 exp. Oct.2011.
PRC. 0139816 ex. Dec.2013