UNIVERSITY OF SAN JOSE-RECOLETOS COLLEGE OF NURSING, CORNER P.

LOPEZ ST & MAGALLANES ST CEBU CITY PHILIPPINES 6000 PHONE: 032 253 7900 Loc 543; FAX: 032254 1720;www.usjr.edu.ph ACTUAL DELIVERY in CEBU CITY MEDICAL CENTER,CEBU CITY CEBU Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name with Signature of Student: OCAMPO,ELGIN RAYE M.

ICNB Form
IMMEDICATE CARE OF THE NEWBORN FORM

Date Performed and Time Started

Patients INITIALS (only) Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Immediate Newborn CORD CARE Performed (Indicate where performed e.g. DR, Nursery, NICU, Home)

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required)

SUPERVISED BY Clinical Instructor (Name and Signature)

September 09, 2010 12:04 am

J. C. D. Delivery room 203760 Joy N. Milan, RN Cipri-ana B. Sanford , RN

UNIVERSITY OF SAN JOSE-RECOLETOS

COLLEGE OF NURSING, CORNER P. LOPEZ ST & MAGALLANES ST CEBU CITY PHILIPPINES 6000 PHONE: 032 253 7900 Loc 543; FAX: 032254 1720;www.usjr.edu.ph

ACTUAL DELIVERY in MINGLANILLA MATERNAL AND CHILD BIRTHING HOME,MINGLANILLA ,CEBU CITY, CEBU Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name with Signature of Student: OCAMPO,ELGIN RAYE M.

ICNB Form

IMMEDICATE CARE OF THE NEWBORN FORM

Date Performed and Time Started

Patients INITIALS (only) Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Immediate Newborn CORD CARE Performed (Indicate where performed e.g. DR, Nursery, NICU, Home)

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required)

SUPERVISED BY Clinical Instructor (Name and Signature)

November 02, 2010 9:25 am

C. P. 10621

Delivery Room

Janice Danielle A. Berdin, RN

Bienvenida E. Samson, RN, MAN

UNIVERSITY OF SAN JOSE-RECOLETOS COLLEGE OF NURSING, CORNER P. LOPEZ ST & MAGALLANES ST CEBU CITY PHILIPPINES 6000

PHONE: 032 253 7900 Loc 543; FAX: 032254 1720;www.usjr.edu.ph ACTUAL DELIVERY in EVERSLEY CHILD SANITARIUM,MANDUAE CITY,CEBU Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name with Signature of Student: OCAMPO,ELGIN RAYE M.

ICNB Form
IMMEDICATE CARE OF THE NEWBORN FORM

Date Performed and Time Started

Patients INITIALS (only) Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Immediate Newborn CORD CARE Performed (Indicate where performed e.g. DR, Nursery, NICU, Home)

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required)

SUPERVISED BY Clinical Instructor (Name and Signature)

November 15, 2010

S.Q. 100653

Delivery Room

Cherry B. Arellano ,RN

Rhea Mae Chaves RN, MAN

UNIVERSITY OF SAN JOSE-RECOLETOS COLLEGE OF NURSING, CORNER P. LOPEZ ST & MAGALLANES ST CEBU CITY PHILIPPINES 6000 PHONE: 032 253 7900 Loc 543; FAX: 032254 1720;www.usjr.edu.ph

ACTUAL DELIVERY in CEBU CITY MEDICAL CENTER, CEBU CITY, CEBU Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name with Signature of Student: OMALAY, MA. LORNA A.
Patients INITIALS (only) Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Immediate Newborn CORD CARE Performed (Indicate where performed e.g. DR, Nursery, NICU, Home) D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required)

ICNB Form
IMMEDICATE CARE OF THE NEWBORN FORM

Date Performed and Time Started

SUPERVISED BY Clinical Instructor (Name and Signature)

July 15, 2010 10:52 pm May 5, 2011 8:05 pm

C.S.O. 367417 S. T. M. 248985

Delivery room

Liezl A. Desquitado, RN

Teresita Liba Grace Undaloc , RN ,MAN Gemma C. Amazon, RN, MAN

Delivery room

Ma. Arnil C. Arceo, RN

UNIVERSITY OF SAN JOSE-RECOLETOS COLLEGE OF NURSING, CORNER P. LOPEZ ST & MAGALLANES ST CEBU CITY PHILIPPINES 6000 PHONE: 032 253 7900 Loc 543; FAX: 032254 1720;www.usjr.edu.ph

ACTUAL DELIVERY in MINGLANILLA MATERNAL AND CHILD BIRTHING HOME,MINGLANILLA ,CEBU CITY, CEBU Hospital/Home/Lying-in Clinic, Municipality/City/Province Prepared by: Printed Name with Signature of Student: OMALAY MA. LORNA A.

ICNB Form

IMMEDICATE CARE OF THE NEWBORN FORM

Date Performed and Time Started

Patients INITIALS (only) Case Number (not applicable for Birthing/Lying-in Clinics/Homes) Immediate Newborn CORD CARE Performed (Indicate where performed e.g. DR, Nursery, NICU, Home)

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required)

SUPERVISED BY Clinical Instructor (Name and Signature)

July 31, 2010 2:12 am

R.N.L Delivery room 10428 Janice Danielle A. Berdin, RN Buenvinida E. Samson, RN ,MAN