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SURGICAL SCRUB (MAJOR AND MINOR) IN ARMED FORCES OF THE PHILIPPINES MEDICAL CENTER

Prepared by: (Indicate your name, surname first) Printed Name and Signature of Student: (Indicate your name, surname first and signature above your name) Date Performed and Time Started (Ex. April 30, 2012) (0902H) Patients INITIAL Only Case Number (ex. Bose, Hernando Palope) (122759) Surgical Procedure Performed (ex. Total Thyroidectomy) O.R. Nurse on Duty (Name and Signature) (ex. 1LT Romel V. Tolentino, RN) Supervised by: Clinical Instructor (Name and Signature) (ex. Mrs. Yolanda Quetua, RN, MAN)

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