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  • Medical For Coaches Asst Coaches Chaperones

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    Kim Pecenio Moralidad
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    This medical certificate certifies that Joan Marie C. Salayog, age 34, was examined and found physically fit to participate in 3x3 basketball for girls at the secondary level up to the Palarong Pambansa competition. The physician conducted a physical examination and recorded her height, weight, blood pressure, pulse rate, and respiration rate, finding her fit to compete. The form is signed by the examining physician and provides their medical license information.

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    Medical-for-Coaches-Asst-Coaches-Chaperones

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    This medical certificate certifies that Joan Marie C. Salayog, age 34, was examined and found physically fit to participate in 3x3 basketball for girls at the secondary level up to the Palarong Pambansa competition. The physician conducted a physical examination and recorded her height, weight, blood pressure, pulse rate, and respiration rate, finding her fit to compete. The form is signed by the examining physician and provides their medical license information.

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    © All Rights Reserved
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    Download as doc, pdf, or txt
    16 views2 pages

    Medical For Coaches Asst Coaches Chaperones

    Uploaded by

    Kim Pecenio Moralidad
    This medical certificate certifies that Joan Marie C. Salayog, age 34, was examined and found physically fit to participate in 3x3 basketball for girls at the secondary level up to the Palarong Pambansa competition. The physician conducted a physical examination and recorded her height, weight, blood pressure, pulse rate, and respiration rate, finding her fit to compete. The form is signed by the examining physician and provides their medical license information.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    of 2

    Revised as of September 26, 2019

    Republic of the Philippines MCForm - 3


    DEPARTMENT OF EDUCATION
    ____________1____________
    (Region)
    _SCHOOLS DIVISION OFFICE 2 PANGASINAN
    (Division)
    CABANBANAN NATIONAL HIGH SCHOOL
    (School)
    CABANBANAN, MANAOAG, PANGASINAN
    (School Address)

    MEDICAL CERTIFICATE
    (COACHES, ASSISTANT COACHES, CHAPERONE)

    SEPTEMBER 20, 2019


    (Date)
    To Whom It May Concern:

    This is to certify that I have personally examined SALAYOG, JOAN MARIE C.


    Name
    age 34 sex FEMALE and have found that he/she is physically fit unfit,

    during the time of examination, to join and participate in the lower meets up to Palarong

    Pambansa.

    Event: 3X3 BASKETBALL GIRLS SECONDARY

    Physical Examination

    School/Intrams/District Meet Remarks/Findings:

    ________________________________________ Ht ._______cm Wt:_______kg FIT


    Physician/Medical Officer
    BP.____________mmHg
    (signature over printed name) UNFIT
    PRC PR:____________bpm
    LICENSE: PTR NO. Date:
    RR:____________cpm

    Unit/Division Meet Remarks/Findings:

    ________________________________________ Ht ._______cm Wt:_______kg FIT


    Physician/Medical Officer
    BP.____________mmHg
    (signature over printed name) UNFIT
    PRC PR:____________bpm
    LICENSE: PTR NO. Date:
    RR:____________cpm
    Regional Meet Remarks/Findings:

    ________________________________________ Ht ._______cm Wt:_______kg FIT


    Physician/Medical Officer
    BP.____________mmHg
    (signature over printed name) UNFIT
    PRC PR:____________bpm
    LICENSE: PTR NO. Date:
    RR:____________cpm

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


    Republic of the Philippines MCForm - 3
    DEPARTMENT OF EDUCATION
    ____________1____________
    (Region)
    _SCHOOLS DIVISION OFFICE 2 PANGASINAN
    (Division)
    CABANBANAN NATIONAL HIGH SCHOOL
    (School)
    CABANBANAN, MANAOAG, PANGASINAN
    (School Address)

    Palarong Pambansa Remarks/Findings:

    ________________________________________ Ht ._______cm Wt:_______kg FIT


    Physician/Medical Officer
    BP.____________mmHg
    (signature over printed name) UNFIT
    PRC PR:____________bpm
    LICENSE: PTR NO. Date:
    RR:____________cpm

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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