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Actual Delivery

This document is a form from Colegio San Agustin - Bacolod College of Health and Allied Professions for recording actual deliveries performed by examinees. It includes fields to record the date and time of the delivery, the patient's initials, the procedure performed, the delivery room nurse on duty, the clinical instructor supervising, and spaces for signatures of the clinical coordinator and dean approving the delivery.

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47 views1 page

Actual Delivery

This document is a form from Colegio San Agustin - Bacolod College of Health and Allied Professions for recording actual deliveries performed by examinees. It includes fields to record the date and time of the delivery, the patient's initials, the procedure performed, the delivery room nurse on duty, the clinical instructor supervising, and spaces for signatures of the clinical coordinator and dean approving the delivery.

Uploaded by

garceniego29
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

COLEGIO SAN AGUSTIN – BACOLOD ODC FORM 1A

ACTUAL DELIVERY ROOM


COLLEGE OF HEALTH AND ALLIED PROFESSIONS
P.O. Box 120, B.S. Aquino Drive
Bacolod City 6100 Philippines
CSA-B Website : www.csab.edu.ph
CHED RECOGNIZED : No. 119, June 2, 1975

NURSING PROGRAM

PHILIPPINE ACCREDITING ASSOCIATION OF SCHOOLS, COLLEGES & UNIVERSITIES


(PAASCU LEVEL III ACCREDITED) valid until May 2025

ACTUAL DELIVERY in : ____________________________________________________________

Prepared by : ___________________________________
EXAMINEE

DATE PATIENT’S INITIAL ONLY PROCEDURE PERFORMED D.R. Nurse On Duty SUPERVISED BY:
PERFORMED & TIME STARTED Case Number (Name & Signature) Clinical Instructor
(Not Applicable for Birthing/Lying in Clinics/ (If Midwife on Duty Signature Not Name & Signature
Homes) HANDLED DELIVERY Required)

Noted by : CLINICAL COORDINATOR Approved by : Dean

HELEN S. SALGADO, RN, MAN REYMA M. MAGBANUA, Ph.D, RN


PRC No : 0240790 Valid Until : September 3, 2024 PRC No : 0282438 Valid Until : May 10, 2026
Date Document is signed : Time : Date Document is signed : Time :
Highest Nursing Degree Earned: BSN, MAN Highest Nursing Degree Earned: PhD, RN

(STRICTLY NO DESIGNATES)

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