REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATION COMMISSION

BOARD OF NURSING
Adapted by: Far Eastern University

Prepared by:
Name of Student: DAILY, JAMES EARNESTH GUZON

Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila

Accreditation Level : Level II PAASCU Re-Accredited Year Granted :March 31, 2001

Date School / Program was Recognized : April 10, 1958 Number : 66 Year : 1958

First Course (if any) : None School Graduated from : Not Applicable

Year of Admission in the Bachelor of Science in Nursing Program : 2006

Year Graduated (BSN Program) : 2010

I. MAJOR OPERATIONS
Supervised by
Date of
No Case Name of Operation Type of Name of Name of Name of O.R Scrub (Name & Signature
Operati Diagnosis
. No. Patient Performed Anesthesia Surgeon Hospital Nurse of Qualified Clinical
on
Instructor)
Third Digit
Ray Amputation
August Marbel Gangrene Right Jesus Duenas Sr., Dr. Fe Del Mundo Ma. Emelita Luansing,
1 507 Third Digit Right Axillary Block Casey de Guzman, RN
20, 2009 Aguirre Hand Secondary to MD Medical Center RN, MAN
Hand, Debridement
Diabetes Mellitus
Osteoarthritis Hip
Total Hip
August Noemi Right secondary to Jesus Duenas Sr., Dr. Fe Del Mundo Ma. Emelita Luansing,
2 510 Replacement Spinal Josephine Meija, RN
22, 2009 Cristobal Dysplasia with MD Medical Center RN, MAN
Arthroplasty Right
Subluxation
Gravida 1 Parity 0,
Pregnancy Uterine,
August Mimi Delos 39 Weeks Age of Antoinette Dr. Fe Del Mundo Ma. Emelita Luansing,
3 09214 Caesarean Section Spinal Eufrosina Alacar, RN
26, 2009 Reyes Gestation, Cephalic, Dimaano, MD Medical Center RN, MAN
Thickly Meconium
Stained
Gravida 1 Parity 0,
Pregnancy Uterine,
August Jocelyn 39 Weeks Age of Low Segment Norma Aguilar, Dr. Fe Del Mundo Ma. Emelita Luansing,
4 09216 Spinal Lourance Feraer, RN
31, 2009 Pasiwlan Gestation, Cephalic, Caesarean Section MD Medical Center RN, MAN
Arrest in Cervical
Dilatation
Total Abdominal
March Lourdes Hysterectomy Dr. Fe Del Mundo Ma. Emelita Luansing,
5 699 Myoma Uteri Spinal Cynthia Tan, MD Ramelito Barrientos, RN
31, 2010 Bordador Bilateral Salphingo- Medical Center RN, MAN
Oophorectomy
Noted by: Concurred by: Noted by:

ELIZABETH F. HACIÑAS, RN, RM, MAN ____ CARMELA O. MANZA, RN, MAN_______ _ GLENDA S. ARQUIZA RN, Ph.D.
Signature over printed Name of Clinical Coordinator Signature over printed Name of Chief Nurse
Date Signed: Date Signed: _________
Signature over printed Name of Dean
Degree: Master of Arts in Nursing Degree:_ __________Master of Arts in Nursing _________
Date Signed:
a.) PRC No.: 0101726 a.) PRC No.: 0090730 _________
Degree: Doctor of Philosophy, Major in Educational
Valid until: July 01, 2011 ___ Valid until: July 5, 2011____________ _________
Administration
b.) PNA No.: 4870 __ b.) PNA No.: 6231 ___________________
a.) PRC No.: 0043483
Valid until: Lifetime Valid until: Lifetime _________
Valid until: December 31, 2010
c.) ANSAP No.: 090506 _________
Valid until: March 2011 _________
_ b.) PNA No.: 19071

Valid until: Lifetime

c.) ADPCN No.: 0786
Valid until: ___ May 31, 2010_____________
_

REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATION COMMISSION
BOARD OF NURSING
Adapted by: Far Eastern University
Prepared by:
Name of Student: DAILY, JAMES EARNESTH GUZON

Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila

Accreditation Level : Level II PAASCU Re-Accredited Year Granted :March 31, 2001

Date School / Program was Recognized : April 10, 1958 Number : 66 Year : 1958

First Course (if any) : None School Graduated from : Not Applicable

Year of Admission in the Bachelor of Science in Nursing Program : 2006

Year Graduated (BSN Program) : 2010

II. MINOR OPERATIONS

Supervised by
Date of
No Case Name of Operation Type of Name of Name of Name of O.R Scrub (Name & Signature
Operati Diagnosis
. No. Patient Performed Anesthesia Surgeon Hospital Nurse of Qualified Clinical
on
Instructor)
Dislocated Intraocular Lens
August Bella Intravenous Jason Soriano, Dr. Fe Del Mundo Ma. Emelita Luansing,
1 4613 Intraocular Lens, Repositioning, Left Mary Ann Buluran, RN
20, 2009 Baldonado Sedation MD Medical Center RN, MAN
Left Eye Eye
 Phacoemulsion with
August Marinas Senile Mature Monitored Jason Soriano, Dr. Fe Del Mundo Ma. Emelita Luansing,
2 4612 Intraocular Lens, Mary Ann Buluran, RN
20, 2009 Carlos Cataract, Left Eye Anesthesia Care MD Medical Center RN, MAN
Left Eye
Abnormal Uterine
August Ma. Yvette Bleeding Rule Out Fractional Dilatation Intravenous Judith Cabanilag, Dr. Fe Del Mundo Ma. Emelita Luansing,
3 09210 Kerwin Gulle, RN
21, 2009 Bausa Endometrial and Curettage Sedation MD Medical Center RN, MAN
Bleeding
Chronic Renal
Septemb
Maria Failure secondary Arterio-Venous Rector Villajuan, Dr. Fe Del Mundo Ma. Emelita Luansing,
4 er 5, 524 Local Dona Rica Cuano, RN
Oracion to Hypertensive Fistula Creation MD Medical Center RN, MAN
2009
Nephrosclerosis
Diverticulosis,
Intestinal
Septemb General
Parasitism, Rectal Colonoscopy with Dr. Fe Del Mundo Ma. Emelita Luansing,
5 er 9, 00051 Nila Rivera Anesthesia thru Robert Tan, MD Casey de Guzman, RN
Polyps, Mixed Biopsy Medical Center RN, MAN
2009 Intravenous
Hemorrhoids Status
Post Biopsy

Noted by: Concurred by: Noted by:

ELIZABETH F. HACIÑAS, RN, RM, MAN ____ CARMELA O. MANZA, RN, MAN_______ _ GLENDA S. ARQUIZA, RN, Ph.D.
Signature over printed Name of Clinical Coordinator Signature over printed Name of Chief Nurse
Date Signed: Date Signed: _________
Signature over printed Name of Dean
Degree: Master of Arts in Nursing Degree:_ __________Master of Arts in Nursing _________
Date Signed:
a.) PRC No.: 0101726 a.) PRC No.: 0090730 _________
Degree: Doctor of Philosophy, Major in Educational
Valid until: July 01, 2011 ___ Valid until: July 5, 2011____________ _________
Administration
b.) PNA No.: 4870 __ b.) PNA No.: 6231 ___________________
a.) PRC No.: 0043483
Valid until: Lifetime Valid until: Lifetime _________
Valid until: December 31, 2010
c.) ANSAP No.: 090506 _________
Valid until: March 2011 _________
_ b.) PNA No.: 19071

Valid until: Lifetime

c.) ADPCN No.: 0786
Valid until: ___May 31, 2010___________ __
_
 REPUBLIC OF THE PHILIPPINES
PROFESSIONAL REGULATION COMMISSION
BOARD OF NURSING
Adapted by: Far Eastern University

Prepared by:
Name of Student: DAILY, JAMES EARNESTH GUZON

Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila

Accreditation Level : Level II PAASCU Re-Accredited Year Granted :March 31, 2001

Date School / Program was Recognized : April 10, 1958 Number : 66 Year : 1958

First Course (if any) : None School Graduated from : Not Applicable

Year of Admission in the Bachelor of Science in Nursing Program : 2006

Year Graduated (BSN Program) : 2010

III. ACTUAL DELIVERIES

Supervised by
No Name of Ag Date of Time of Gender of Type of
Case No. Diagnosis Name of Hospital (Name & Signature of Qualified
. Mother e Delivery Delivery Baby Delivery
Clinical Instructor)
Gravida 1 Parity 0,
Cristina S. Velasquez Normal
Pregnancy Uterine, 40 February 10,
1 Sherly Ann Tan 15 3:27 PM Female Maternity and Lying- Spontaneous Lorna Defiño RN, RM, MAN
090133 Weeks Age of Gestation, 2009
In Clinic Delivery
Cephalic, In Labor
Gravida 5 Parity 4,
Normal
Pregnancy Uterine, 37-38 October 21, Mauway Lying-In
2 3105 Lina Morales 39 10:34 AM Female Spontaneous Victoria Gandullas, RN, MAN
Weeks Age of Gestation, 2009 Clinic
Delivery
Cephalic, In Labor
Gravida 3 Parity 2,
Normal
Pregnancy Uterine, 38 Mylene October 22, Mauway Lying-In
3 3117 30 7:35 AM Female Spontaneous Victoria Gandullas, RN, MAN
Weeks Age of Gestation, Martinez 2009 Clinic
Delivery
Cephalic, In Labor
Gravida 5 Parity 4,
Normal
Pregnancy Uterine, 37-38 Jean October 23, Mauway Lying-In
4 3133 31 1:36 PM Female Spontaneous Victoria Gandullas, RN, MAN
Weeks Age of Gestation, Montemayor 2009 Clinic
Delivery
Cephalic, In Labor
Gravida 2 Parity 1,
Normal
Pregnancy Uterine, 40 October 24, 9:05 AM Mauway Lying-In
5 Elsa Bonggay 32 Female Spontaneous Victoria Gandullas, RN, MAN
1346 Weeks Age of Gestation, 2009 Clinic
Delivery
Cephalic, In Labor
Noted by: Concurred by: Concurred by: Approved by:

ELIZABETH F. HACIÑAS, RN, RM, CRISTINA S. VELASQUEZ, JENECIA N. EUGENIO, RN, MPH, GLENDA S. ARQUIZA RN,
MAN _ RM____________ MAN____________ Ph.D._________________
Signature over printed Name of Clinical Signature over printed Name of Signature over printed Name of Chief Nurse Signature over printed Name of Dean
Coordinator Owner/Administrator Date Signed: Date Signed:
Date Signed: Date Signed: Degree: Master of Public Health, Degree: Doctor of Philosophy, Major in
Degree: Master of Arts in Degree:____ Graduate in Midwifery Master of Arts in Nursing Educational Administration
Nursing _ a.) PRC No. 0090446 a.) PRC No.: 0043483
a.) PRC No.: 0101726 a.) PRC No.: 85175 Valid until: December 11, 2011__
Valid until: July 01, 2011 ___ Valid until: _December 2013 __________ _
Valid until: December 31, 2010
b.) PNA No.: 4870 __ ______________ ___ b.) PNA No.: 17827
Valid until: Lifetime b.) IMAP No.: 2866 ________ __
Valid until: December 31, 2010 Valid until: Lifetime b.) PNA No.: 19071
_
c.) ANSAP No.: 01199
Valid until: Lifetime
Valid until: Lifetime _______

c.) ADPCN No.: 0786

Valid until: ____May 31, 2010_____________
_________________________

REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATION COMMISSION
BOARD OF NURSING
Adapted by: Far Eastern University
Prepared by:
Name of Student: DAILY, JAMES EARNESTH GUZON

Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila

Accreditation Level : Level II PAASCU Re-Accredited Year Granted :March 31, 2001

Date School / Program was Recognized : April 10, 1958 Number : 66 Year : 1958

First Course (if any) : None School Graduated from : Not Applicable

Year of Admission in the Bachelor of Science in Nursing Program : 2006

Year Graduated (BSN Program) : 2010

IV. DELIVERIES ASSISTED

Supervised by
Date of Time of Gender (Name & Signature of
No. Case No. Diagnosis Name of Mother Age Name of Hospital Type of Delivery
Delivery Delivery of Baby Qualified Clinical
Instructor)
 Gravida 2 Parity 1,
Cristina S. Velasquez Normal
Pregnancy Uterine, 40 February 9,
1 Rowena Carillo 31 2:45 PM Female Maternity and Lying-In Spontaneous Lorna Defiño RN, RM, MAN
090129 Weeks Age of Gestation, 2009
Clinic Delivery
Cephalic, In Labor
Gravida 2 Parity 1,
Cristina S. Velasquez Normal
Pregnancy Uterine, 40 February 17,
2 090151 Hedeliza Vargas 26 1:20 PM Female Maternity and Lying-In Spontaneous Lorna Defiño RN, RM, MAN
Weeks Age of Gestation, 2009
Clinic Delivery
Cephalic, In Labor
Gravida 5 Parity 4,
Normal
Pregnancy Uterine, 38 October 21, Victoria Gandullas, RN,
3 3107 Elmira Cauyon 34 12:25 PM Male Mauway Lying-In Clinic Spontaneous
Weeks Age of Gestation, 2009 MAN
Delivery
Cephalic, In Labor
Gravida 4 Parity 3,
Normal
Pregnancy Uterine, 38-39 October 23, Victoria Gandullas, RN,
4 3130 Cindy Mere Lerio 31 8:35 AM Female Mauway Lying-In Clinic Spontaneous
Weeks Age of Gestation, 2009 MAN
Delivery
Cephalic, In Labor
Gravida 3 Parity 2,
Normal
Pregnancy Uterine, 38 October 24, Victoria Gandullas, RN,
5 3146 Geraldine Paboneta 36 11:56 PM Female Mauway Lying-In Clinic Spontaneous
Weeks Age of Gestation, 2009 MAN
Delivery
Cephalic, In Labor

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

ELIZABETH F. HACIÑAS, RN, RM, CRISTINA S. VELASQUEZ, JENECIA N. EUGENIO, RN, MPH, GLENDA S. ARQUIZA RN,
MAN _ RM____________ MAN____________ Ph.D._________________
Signature over printed Name of Clinical Signature over printed Name of Signature over printed Name of Chief Nurse Signature over printed Name of Dean
Coordinator Owner/Administrator Date Signed: Date Signed:
Date Signed: Date Signed: Degree: Master of Public Health, Degree: Doctor of Philosophy, Major in
Degree: Master of Arts in Degree:____ Graduate in Midwifery Master of Arts in Nursing Educational Administration
Nursing _ a.) PRC No. 0090446 a.) PRC No.: 0043483
a.) PRC No.: 0101726 a.) PRC No.: 85175 Valid until: December 11, 2011__
Valid until: July 01, 2011 ___ Valid until: _December 2013 __________ _
Valid until: December 31, 2010
b.) PNA No.: 4870 __ ______________ ___ b.) PNA No.: 17827
Valid until: Lifetime b.) IMAP No.: 2866 ________ __
Valid until: December 31, 2010 Valid until: Lifetime b.) PNA No.: 19071
_
c.) ANSAP No.: 01199
Valid until: Lifetime
Valid until: December 2010 _______

c.) ADPCN No.: 0786

Valid until: ____May 31, 2010_____________
_________________________

REPUBLIC OF THE PHILIPPINES

PROFESSIONAL REGULATION COMMISSION
BOARD OF NURSING
Adapted by: Far Eastern University
Prepared by:
Name of Student: DAILY, JAMES EARNESTH GUZON

Name and Address of School : Far Eastern University, Nicanor Reyes Sr. Street Sampaloc Manila

Accreditation Level : Level II PAASCU Re-Accredited Year Granted :March 31, 2001

Date School / Program was Recognized : April 10, 1958 Number : 66 Year : 1958

First Course (if any) : None School Graduated from : Not Applicable

Year of Admission in the Bachelor of Science in Nursing Program : 2006

Year Graduated (BSN Program) : 2010

V. CORD DRESSING
Supervised by
(Name & Signature of
No. Case No. Date Performed Name of Baby Gender of Baby Name of Mother Age Name of Hospital
Qualified
Clinical Instructor)
Cristina S. Velasquez
1 090128 February 9, 2009 Baby Girl Panillo Female Jocelyn Panillo 28 Maternity and Lying-In Lorna Defiño RN, RM, MAN
Clinic
Cristina S. Velasquez
2 090147 February 16, 2009 Baby Girl Sibayan Female Marina Sibayan 28 Maternity and Lying-In Lorna Defiño RN, RM, MAN
Clinic

3 3108 October 21, 2009 Baby Boy Oreas Male Charlene Oreas 23 Mauway Lying-In Clinic Victoria Gandullas, RN, MAN

4 3132 October 23, 2009 Baby Girl Seelo Female Raquel Seelo 31 Mauway Lying-In Clinic Victoria Gandullas, RN, MAN

5 3147 October 24, 2009 Baby Girl Woniwon Female Genevive Woniwon 22 Mauway Lying-In Clinic Victoria Gandullas, RN, MAN
Noted by: Concurred by: Concurred by: Approved by:

ELIZABETH F. HACIÑAS, RN, RM, CRISTINA S. VELASQUEZ, JENECIA N. EUGENIO, RN, MPH, GLENDA S. ARQUIZA RN,
MAN _ RM____________ MAN____________ Ph.D._________________
Signature over printed Name of Clinical Signature over printed Name of Signature over printed Name of Chief Nurse Signature over printed Name of Dean
Coordinator Owner/Administrator Date Signed: Date Signed:
Date Signed: Date Signed: Degree: Master of Public Health, Degree: Doctor of Philosophy, Major in
Degree: Master of Arts in Degree:____ Graduate in Midwifery Master of Arts in Nursing Educational Administration
Nursing _ a.) PRC No. 0090446 a.) PRC No.: 0043483
a.) PRC No.: 0101726 a.) PRC No.: 85175 Valid until: December 11, 2011__
Valid until: July 01, 2011 ___ Valid until: _December 2013 __________ _
Valid until: December 31, 2010
b.) PNA No.: 4870 __ ______________ ___ b.) PNA No.: 17827
Valid until: Lifetime b.) IMAP No.: 2866 ________ __
Valid until: December 31, 2010 Valid until: Lifetime b.) PNA No.: 19071
_
c.) ANSAP No.: 01199
Valid until: Lifetime
Valid until: Lifetime _______

c.) ADPCN No.: 0786

Valid until: ____May 31, 2010_____________
_________________________