St.
Scholastica’s College Tacloban
COLLEGE OF NURSING
Brgy. Campetic Maharlika Highway Palo, Leyte
_______________________
Chief of Hospital
Divine Word Hospital
Thru:
_______________________
Chief Nurse
Divine Word Hospital
Dear Ma’am,
Greetings!
The 4th year Nursing Students of St. Scholastica’s College Tacloban is requesting to have
their ON-CALL DUTY in your hospital at the Operating Room. The duty is to complete their
requirements needed for graduation.
In this regard, the undersigned would like to ask permission from your office to allow our
students to go on the schedule/s and area/s written below with their assigned clinical instructor.
AREA: __________________________________________
DATE: __________________________________________
TIME:___________________________________________
CLINICAL INSTRUCTOR: _________________________
NAME OF STUDENTS:
1. Hobayan, Jessa Mary Joy 4. Pegon, Mikki
2. Moslares, Devy Nicole 5. Pido, Joy Marie
3. Muyalde, Patrishe Isabel 6. Rodreguez, Rena Rose
Thank you and we look forward for your positive response on this regard.
Respectfully yours, Recommending Approval
_____________________
MRS. WILMA M. RUIZ, RN, MAN Chief Nurse
Level IV Coordinator
Noted by: Approved by:
DR. CAROLINA D. BARROT, RN, MAN ____________________
Dean, College of Nursing Chief of Hospital