PHYSICAL FITNESS RECORD

NAME OF STUDENT:
GRADE AND SECTION:
Health Related Pre-Test 2nd Qtr. 3rd Qtr. Post Test
components 1st Qtr. Monitoring Monitoring 4th Qtr.
Height (m) :
Weight. (kgs) :
Body Mass
Result and Category:
Index(BMI) and
Waist Hip Ratio Waist (cm):
(WHR) Hip (cm):
Result:
Cardio vascular Before: bpm
Endurance After: bpm
Gap/overlap Right: (cm)
Gap/overlap Left: (cm)
Flexibility
Sit and Reach: (cm)
Middle Score:
No. of push-up
Strength
Time for plank (sec.)

Skill Related Pre-Test 2nd Qtr. 3rd Qtr. Post Test

component 1st Qtr. Monitoring Monitoring 4th Qtr.
Clockwise (sec.)
Counter clockwise (sec.)
Agility
Average:
Right foot time: (sec)
Balance
Left foot time: (sec)

No. of Juggling
Coordination
First trial: (cm)
Power
Second trial: (cm)

1st trial: (inches)

2nd trial: (inches)
Reaction Time 3rd Trial: (inches)
Middle score: (cm)
Nearest seconds
Speed

Points of improvement

Overall physical assessment test

Student’s name and signature

Teacher’s name and Signature

 ASSESSMENT CARD:

Health Related 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. LEGEND
components
< 18.5=UNDEREWEIGHT
Body
18.6-25=NORMAL
Composition:
25.1-29.9= OVERWEIGHT
BMI
>30=OBESE
WHR
85.5 + BPM = HIGH
Cardio vascular 85-95=MODERATE
Endurance 95.5-199.5=FAIR
120 AND ABOVE= LOW

Flexibility

Strength
Skill Related
component

Agility

Balance

Coordination

Power

Reaction Time

CATEGORY BOYS GIRLS

Speed GOOD TO BETTER 6.3-7 7-7.9

AVERAGE 7.1-7.5 8-8.7
FAIR 7.6-8.5 8.8-10.3
LOW 8.6+ 10.4+