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PRC Form Guide

This document contains sample data from major and minor operations and actual and assisted deliveries from a hospital. For the major and minor operations section, it lists 3 procedures including a cesarean section, biopsy, and cataract surgery with details such as patient name, diagnosis, procedure, anesthesia used, surgeon and hospital. For the deliveries section, it describes 2 births including details of the mother, age, date of delivery, baby's gender and type of delivery along with the hospital and supervisor. This sample data appears to be from a hospital and contains de-identified patient information and procedural details for quality assurance or educational purposes.

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John Mark
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205 views1 page

PRC Form Guide

This document contains sample data from major and minor operations and actual and assisted deliveries from a hospital. For the major and minor operations section, it lists 3 procedures including a cesarean section, biopsy, and cataract surgery with details such as patient name, diagnosis, procedure, anesthesia used, surgeon and hospital. For the deliveries section, it describes 2 births including details of the mother, age, date of delivery, baby's gender and type of delivery along with the hospital and supervisor. This sample data appears to be from a hospital and contains de-identified patient information and procedural details for quality assurance or educational purposes.

Uploaded by

John Mark
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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MAJOR AND MINOR OPERATIONS SAMPLE DATA

Supervised by
Date of Name of Name and Signature of O.R Scrub
No. Case No. Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital (Name & Signature of Qualified
Operation Patient Nurse
Clinical Instructor)
Hospital Maycel PU 40 6/7 Weeks AOG
Data 4/4/09 LTCS SAB Dr. Santos OMMC Elena Esguerra Mr. Richard Loresco
Busadne Single Footling G1 P0
Maycel Pregnancy Uterine 40 6/7 Low Transverse Cesarean
PRC April 04, Dr. Maria Christina Ospital Ng Maynila
Busadne Weeks Of Gestation Single Section Subarachnoid Block Elena M. Esguerra, RN Richard D. Loresco, RN, RM, MAN
Entry 2009 Estella Santos Medical Center
Footling Gravida 1 Para 0
Hospital Josephine Mass; (L) Nasal Cavity Excision Biopsy, (L)
Data 4/4/09 GA-ET Dr. De Jesus OMMC Ms. Anna Limen Mr. Richard Loresco
Maylas
PRC April 04, Josephine Mass; Left Nasal Cavity Biopsy Under General General Endotracheal Ospital Ng Maynila
1378536 Dr. Noel De Jesus Anna F. Limen, RN Richard D. Loresco, RN, RM, MAN
Entry 2009 Maylas Anesthesia Anesthesia Medical Center
Hospital Eliseo CSM (L & R Eye) ECCE w/ PCIOL
Data 4/4/09 GA-IV Dr. Dayacap OMMC Mr. Jose Christopher E. Sison Mr. Richard Loresco
Aglibot
Eliseo Cataract Senile Mature Extra Capsular Cataract
PRC April 05, 1384758 General Anesthesia Ospital Ng Maynila
Aglibot (Left > Right Eye) Extraction With Posterior Dr. Eduardo Dayacap Jose Christopher E. Sison, RN Richard D. Loresco, RN, RM, MAN
Entry 2006 Intravenous Medical Center
Chamber Intraocular Lens

ACTUAL AND ASSISTED DELIVERIES SAMPLE DATA


Time of Supervised by
No. Case No. Diagnosis Name of Mother Age Date of Delivery Gender of Baby Name of Hospital Type of Delivery
Delivery (Name & Signature of Qualified Clinical Instructor)
Hospital
Data G1 P0 PU 39 4/7Wks AOG CIL Jacquelene Felix 19 12/ 25/08 8:05 PM F OMMC NSD Mr. Richard Loresco
Gravida 1 Para 0 Pregnancy Uterine
PRC 19 Years Ospital Ng Maynila Medical Normal Spontaneous
39 – 40 Weeks Age Of Gestation Jacquelene Felix Old December 25, 2008 8:05 PM Female Richard D. Loresco, RN, RM, MAN
Entry Center Delivery
Gestation Cephalic In Labor
Hospital
Data G4 P3 PU 39 5/7 Wks AOG CIL Marivic Enriquez 24 y/o 12/ 26/08 7:10 PM F OMMC NSD Mr. Richard Loresco
Gravida 4 Para 3 Pregnancy Uterine 24
PRC Ospital Ng Maynila Medical Normal Spontaneous
39 - 40 Weeks Of Gestation Marivic Enriquez Years December 26, 2006 7:10 PM Female Richard D. Loresco, RN, RM, MAN
Entry Center Delivery
Cephalic In Labor Old

> do not abbreviate!

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