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  • Topic: Nursing, Bachelor of Science in Nursing, Master of Science in Nursing
  • Pages : 8 (688 words )
  • Download(s) : 221
  • Published : May 11, 2013
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FILAMER CHRISTIAN UNIVERSITY
ROXAS CITY, PHILIPPINES
Tele-Fax No.6213-075/Email: fcc_registrar@yahoo.com
(Accredited by ACSCU- AAI, Level II)

ACTUAL DELIVERY in ____________________________________________________ Hospital/Home/Lying – in Clinic, Municipality/City/Province

Prepared by:
Printed Name and Signature of Student _______________________________________

|Date Performed |Patient’s INITIAL (Only) | |D.R. Nurse On Duty |SUPERVISED BY | |and | |PROCEDURE | |Clinical Instructor | |Time Started | |PERFORMED |(Name and Signature) |Name and Signature | | | | |(If Midwife on Duty, | | | | | |Signature Not Required) | | | |Case Number | | | | | |(not applicable for Birthing/Lying-In Clinics/Homes) | | | | | | | | | | | | | | | | | | | | | |

Noted by: ____________________________________________Approved by: _______________________________________ (Print Name and Signature)(Print Name and Signature) Clinical Coordinator, PRC I.D No.:____________ Valid Until: _____________Dean, PRC I.D No.: ______________ Valid Until __________ Date document is signed: ____________________Time:____________________Date document is signed: _____________Time: _____________ Please specify Highest Nursing Degree Earned: ___________________________Specify Highest Nursing Degree Earned: __________________

(STRICTLY NO DESIGNATES)

FILAMER CHRISTIAN UNIVERSITY
ROXAS CITY, PHILIPPINES
Tele-Fax No.6213-075/Email: fcc_registrar@yahoo.com
(Accredited by ACSCU- AAI, Level II)

IMMEDIATE NEWBORN CORD CARE in _____________________________________________ Hospital/Home/Lying – in Clinic, Municipality/City/Province

Prepared by:
Printed Name and Signature of Student _________________________________________

|Date Performed |Patient’s INITIAL (Only) |Immediate Newborn Cord Care |Nurse On Duty |SUPERVISED BY | |and | |PERFORMED |(Name and Signature) |Clinical Instructor | |Time Started | |(Indicate where performed e.g. D.R. ,...
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