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PROFESSIONAL REGULATION COMMISION

Manila
BOARD OF MIDWIFERY
Record of Actual Deliveries Handled
Please Check:
Graduate Midwife Registered Nurse

Name of Applicant: MICHAEL ANGELO B. SEA School: MABINI COLLEGES, DAET CAMARINES NORTE

Name and Address of Patient
Case
No.
Complete Diagnosis
(Gravida_Para_)
Date &
Time
Performed
Full Name,
Address of Facility
& Contact Number
Check
if
Home
Del.
Supervised by:
Printed Name &
Contact No.
Position/
Designation
Signature
License No./
Expiration Date
1.BATALAO,CATHERINE
CANAPAUAN, LABO C.N.
270304
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-24-13
1:32 AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
2.MARMOLEJO,REINA
LABMIG PARACALE C.N.
260941
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-15-13
11:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
3.ACLANO,ERLIN
IGANG PARACALE C.N.
220848
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
7-6-13
5:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
4.TABUZO,JESSICA
MALANGCAO BASUD LABO C.N.
27055
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-30-13

LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
5.BANING VANESSA
FISHPORT PARACALE C.N.
198041
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
7-31-13
7:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
6.FRANCISCO,HAZEL
TAWIG LABO C.N.
280956
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-14-13
9:15AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
7.PAJARILLO,CHONA
MASALONG LABO C.N.
290142
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-20-13
12:22PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
8.FINALLA,MARICEL
TUGOS,PARACALE C.N.
281742
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-11-13
10:49AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
9.JALIMAO,MARIE
P.MUNT PARACALE
281846
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-13-13
4:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
10.EREPALA,JOCELYN
MACOGON, LABO C.N.
281031
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
10-28-13
5:45AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14

(Continued at the Back)
PRC FORM No. 106
(Revised October 2010)


Name and Address of Patient
Case
No.
Complete Diagnosis
(Gravida_Para_)
Date &
Time
Performed
Full Name,
Address of Facility
& Contact Number
Check
if
Home
Del.
Supervised by:
Printed Name &
Contact No.
Position/
Designation
Signature
License No./
Expiration
Date
11.BRAGA ,LIZA
TUGOS PARACALE C.N.
260781
G3P2 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-10-13
3:45PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
12.JINQUE,EDLYN
GUMAMELA LABO C.N.
280093
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
7-20-13
10:20PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
13.EVALDERASA,SHIELA
NICO PARACALE C.N.
260485
G3P2 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-5-13
2:03AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
14.ESTABYA,ANALYN
TALUSAN PARACALE C.N.
280661
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-15-13
4:35PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
15.PALMERO,RONALIE
MALAGNIT PARACALE C.N.
281223
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-28-13
4:45AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
16.TOLINTINO,NINA
DAGUIT, LABO C.N
283423
G5P4 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
10-23-13
4:15AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
17.GAPOY,ALMA
BAAY LABO C.N.
283336
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
10-19-13
4:05AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
18.ALAPAA,BELMELA
STA.SONA SUR JOSE PANGANIBAN
C.N.
270056
G4P3 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
01-16-13
12:24PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
19.MAGIMPA,NORJEAN
MASALONG LABO C.N.
281980
G3P2 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-17-13
10:30AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
20.NUDO,NERISSA
STA. ROSA NORTE JOSE
PANGANIBAN C.N.
281394
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-20-13
11:18PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14

Note:1) For graduate midwives: Supervision must be by qualified faculty/clinical instructor.






SUBSCRIBED AND SWORN To before me this ____________________ at
_____________________Affiant exhibiting to me his/her Residence Certificate No.
25927910 issued at DAET CAMARINES NORTE on JANUARY 3 2014.

Affix
Documentary Stamp
(to be posted on the last page)
CERTIFIED CORRECT:


Signature: ______________________ Date: ____________
Printed Name: YOLANDA C.RUSTIA RN.RM,MAN o
Designation: PRINCIPAL OF MIDWIFERY o
License Number:0175887/0112842 Expiry Date: SEPT. 25 2016
________________________________________________________
ADMINISTERING OFFICER OR NOTARY CLUB

PROFESSIONAL REGULATION COMMISION
Manila
BOARD OF MIDWIFERY
Record of Actual Suturing of Perineal Laceration
Please Check:
Graduate Midwife Registered Nurse

Name of Applicant: MICHAEL ANGELO B. SEA School: MABINI COLLEGES, DAET CAMARINES NORTE

Name and Address of
Patient
Case
No.
Complete Diagnosis
(Gravida_Para_)
Date &
Time
Performed
Full Name,
Address of Facility
& Contact Number
Check
if
Home
Del.
Supervised by:
Printed Name &
Contact No.
Position/
Designation
Signature
License No./
Expiration
Date
5.BANING VANESSA
FISHPORT PARACALE C.N.
198041
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
7-31-13
7:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
6.FRANCISCO,HAZEL
TAWIG LABO C.N.
280956
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-14-13
9:15AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
7.PAJARILLO,CHONA
MASALONG LABO C.N.
290142
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-20-13
12:22PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
8.FINALLA,MARICEL
TUGOS,PARACALE C.N.
281742
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-11-13
10:49AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
9.JALIMAO,MARIE
P.MUNT PARACALE
281846
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
9-13-13
4:35AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
10.EREPALA,JOCELYN
MACOGON, LABO C.N.
281031
G1P0 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
10-28-13
5:45AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
Note: 1) For graduate midwives: Supervision must be by qualified faculty/clinical instructor.
2) Registered Midwives/Clinical Instructors who supervise student midwives and affix their signature in this Form must present Certificate of Training on
Suturing of Perineal lacerations to the Board pursuant to Board Resolutions No. 100, Series of 1993, dated December 1,1993



(See back page)



PRC FORM No. 107
(Revised October 2010)
SUBSCRIBED AND SWORN To before me this ____________________ at
_____________________Affiant exhibiting to me his/her Residence Certificate No.
25927910 issued at DAET CAMARINES NORTE on JANUARY 3 2014.


PROFESSIONAL REGULATION COMMISION
Manila
BOARD OF MIDWIFERY
Record of Actual Intravenous Insertions


Name of Applicant: MICHAEL ANGELO B. SEA School: MABINI COLLEGES, DAET CAMARINES NORTE

Name and Address of
Patient
Case
No.
Complete Diagnosis
(Gravida_Para_)
Date &
Time
Performed
Full Name,
Address of Facility
& Contact Number
Check
if
Home
Del.
Supervised by:
Printed Name &
Contact No.
Position/
Designation
Signature
License No./
Expiration
Date
11.BRAGA ,LIZA
TUGOS PARACALE C.N.
260781
G3P2 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-10-13
3:45PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
12.JINQUE,EDLYN
GUMAMELA LABO C.N.
280093
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
7-20-13
10:20PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
13.EVALDERASA,SHIELA
NICO PARACALE C.N.
260485
G3P2 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
6-5-13
2:03AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
14.ESTABYA,ANALYN
TALUSAN PARACALE C.N.
280661
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-15-13
4:35PM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
15.PALMERO,RONALIE
MALAGNIT PARACALE C.N.
281223
G2P1 CEPHALOPELVIC
IN LABOR PREGNANCY
UTERINE FULLTERM
8-28-13
4:45AM
LABO,DISTRIC
HOSPITAL
CAMARINES NORTE

RAQUEL R. ABRERA
09273779250
CLINICAL
INSTRUCTOR


L.N.-0134703
0379885
E.D.-07-18-14
Note: 1) For graduate midwives: Supervision must be by qualified faculty/clinical instructor.
2) Registered Midwives/Clinical Instructors who supervise student midwives and affix their signature in this Form must present Certificate of Training on
Suturing of Perineal lacerations to the Board pursuant to Board Resolutions No. 100, Series of 1993, dated December 1,1993





Affix
Documentary Stamp
(to be posted on the last page)
PRC FORM No. 107-A
(Revised October 2010)
________________________________________________________
ADMINISTERING OFFICER OR NOTARY CLUB
CERTIFIED CORRECT:


Signature: ______________________ Date: ____________
Printed Name: YOLANDA C.RUSTIA RN.RM,MAN o
Designation: PRINCIPAL OF MIDWIFERY o
License Number:0175887/0112842 Expiry Date: SEPT. 25 2016

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