This medical certificate is for a student participating in school sports from lower meets up to the Palarong Pambansa national games. It documents the results of a physical examination finding the student physically fit to participate. The examination checked 11 body systems and functions including eyes, ears, cardiovascular system, lungs, muscles and reflexes. The student's height, weight, blood pressure, pulse and respiration rate were also recorded. The physician certified the student is physically fit to participate in competitions at the level of intramural, district, unit/division, regional meets and the Palarong Pambansa national games.
This medical certificate is for a student participating in school sports from lower meets up to the Palarong Pambansa national games. It documents the results of a physical examination finding the student physically fit to participate. The examination checked 11 body systems and functions including eyes, ears, cardiovascular system, lungs, muscles and reflexes. The student's height, weight, blood pressure, pulse and respiration rate were also recorded. The physician certified the student is physically fit to participate in competitions at the level of intramural, district, unit/division, regional meets and the Palarong Pambansa national games.
This medical certificate is for a student participating in school sports from lower meets up to the Palarong Pambansa national games. It documents the results of a physical examination finding the student physically fit to participate. The examination checked 11 body systems and functions including eyes, ears, cardiovascular system, lungs, muscles and reflexes. The student's height, weight, blood pressure, pulse and respiration rate were also recorded. The physician certified the student is physically fit to participate in competitions at the level of intramural, district, unit/division, regional meets and the Palarong Pambansa national games.
This medical certificate is for a student participating in school sports from lower meets up to the Palarong Pambansa national games. It documents the results of a physical examination finding the student physically fit to participate. The examination checked 11 body systems and functions including eyes, ears, cardiovascular system, lungs, muscles and reflexes. The student's height, weight, blood pressure, pulse and respiration rate were also recorded. The physician certified the student is physically fit to participate in competitions at the level of intramural, district, unit/division, regional meets and the Palarong Pambansa national games.
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)
Republic of the Philippines MCForm - 1 DEPARTMENT OF EDUCATION ____________VII__________ (REGION) ________BAYAWAN CITY_______ (DIVISION) School/Intrams/District Meet Remarks/Findings: To Whom It May Concern: ____SAN JOSE, BAYAWAN CITY_____ (SCHOOL) _____________________________ Ht ._______cm FIT Physician/Medical Officer ___SAN JOSE, BAYAWAN CITY___ Wt:_______kg This is to certify that I have personally examined _____________________ (School Address) (signature over printed name) BP.____________mmHg UNFIT Name PRC PR:____________bpm age ____ sex ___ and have found that he/she is physically fit unfit, LICENSE: PTR NO. RR:____________cpm Date: during the time of examination, to join and participate in the lower meets up to Unit/Division Meet Remarks/Findings:
Palarong Pambansa. _____________________________ Ht ._______cm FIT
Physician/Medical Officer Wt:_______kg (signature over printed name) BP.____________mmHg UNFIT PRC PR:____________bpm Event: __________________________________________ LICENSE: PTR NO. RR:____________cpm Date: Regional Meet Remarks/Findings: Physical Examination _____________________________ Ht ._______cm FIT School/ Unit/Division Regional Palarong Physician/Medical Officer Wt:_______kg Intrams/District Meet Meet Pambansa (signature over printed name) BP.____________mmHg UNFIT Meet PRC PR:____________bpm LICENSE: PTR NO. RR:____________cpm Date: Normal Normal Normal Normal Palarong Pambansa Remarks/Findings: 1. Eyes YES | NO YES | NO YES | NO YES | NO 2. Ears, Nose, Throat YES | NO YES | NO YES | NO YES | NO _____________________________ Ht ._______cm FIT 3. Mouth and Teeth YES | NO YES | NO YES | NO YES | NO Physician/Medical Officer Wt:_______kg (signature over printed name) BP.____________mmHg UNFIT 4. Neck YES | NO YES | NO YES | NO YES | NO PRC PR:____________bpm 5. Cardiovascular YES | NO YES | NO YES | NO YES | NO LICENSE: PTR NO. RR:____________cpm Date: 6. Chest and Lungs YES | NO YES | NO YES | NO YES | NO 7. Abdomen YES | NO YES | NO YES | NO YES | NO 8. Skin YES | NO YES | NO YES | NO YES | NO 9. Genitalia-Hernia (male) YES | NO YES | NO YES | NO YES | NO 10. Muskuloskeletal: ROM YES | NO YES | NO YES | NO YES | NO a. neck YES | NO YES | NO YES | NO YES | NO b. spine YES | NO YES | NO YES | NO YES | NO c. shoulder YES | NO YES | NO YES | NO YES | NO d. arms/hands YES | NO YES | NO YES | NO YES | NO e. hips YES | NO YES | NO YES | NO YES | NO f. thighs YES | NO YES | NO YES | NO YES | NO g. knees YES | NO YES | NO YES | NO YES | NO h. ankles YES | NO YES | NO YES | NO YES | NO i. feet YES | NO YES | NO YES | NO YES | NO 11. Neuromuscular YES | NO YES | NO YES | NO YES | NO (reflexes)
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)