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  • Topic: Laparoscopic surgery, Surgery, Nursing
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  • Published : March 18, 2013
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Lyceum of the Philippines University
Capitol Site, Batangas City
(043) 723-0706 loc 109-110/www.lyceumbatangas.edu.ph
PACUCOA ACCREDITED, LEVEL III Reaccredited Status, September 2012 – September 2017 SURGICAL SCRUB in BATANGAS MEDICAL CENTER/ KUMINTANG IBABA/BATANGAS CITY/ BATANGAS

O.R. Form 1B
O.R. CIRCULATING FORM

Prepared by:
Printed Name and Signature of Student GUERRERO ARNEL CLOSA

Date Performed and Time Started| Patient’s INITIALS Case Number| PROCEDURE PERFORMED| D.R Nurse On Duty| SUPERVISED BY| June 17, 20124:50 PM| SE12386| Hip Disacrticulation| Marciano Luya| Suzette Florentino|

Concurred by:Approved by:

AMOR B. CALAYAN, RN RM MAN PhDCECILIA C. PRING, RN MAN PhD
Chief Nurse Dean, College of Nursing

Lyceum of the Philippines University
Capitol Site, Batangas City
(043) 723-0706 loc 109-110/www.lyceumbatangas.edu.ph
PACUCOA ACCREDITED, LEVEL III Reaccredited Status, September 2012 – September 2017 SURGICAL SCRUB in BATANGAS HEALTH JESUS OF CARE HOSPITAL- NAZARETH/ GULOD ITAAS/ BATANGAS CITY/ BATANGAS

O.R. Form 1B
O.R. CIRCULATING FORM

Prepared by:
Printed Name and Signature of Student GUERRERO ARNEL CLOSA

Date Performed and Time Started| Patient’s INITIALS Case Number| PROCEDURE PERFORMED| D.R Nurse On Duty| SUPERVISED BY| January 23, 20132:30 PM| NM13534| Laparoscopic Cholecystectomy with Intraoperative Cholangiogram| Melanie Sevilla| Gloria Ceniza| January 23, 20135:02 PM| DC23060| Phacoemulsification Posterior Chamber Intra-Ocular Lens Cataract Surgery, Left Eye| Melanie Sevilla| Gloria Ceniza|

Concurred by:Approved by:

GLORIA G. CENIZA, RN MAN PhDCECILIA C. PRING, RN MAN PhD Chief Nurse Dean, College of Nursing
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