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  • Medical For Coaches Asst Coaches Chaperones - v2023

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    mark joseph quicho
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    This medical certificate certifies that Marites L. Painaga, a 57 year old female, was examined on January 12, 2012 and found to be physically fit to participate in lower meets up to the Palarong Pambansa for the event of Arnis - Boys. The certificate contains spaces to record physical examination findings for school/intramural district meets, division meets, regional meets, and the Palarong Pambansa, to be filled out and signed by a physician. It confirms that the examinee is medically cleared to participate in school sporting events up to the national level competition.

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    Medical-for-Coaches-Asst-Coaches-Chaperones_v2023

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    This medical certificate certifies that Marites L. Painaga, a 57 year old female, was examined on January 12, 2012 and found to be physically fit to participate in lower meets up to the Palarong Pambansa for the event of Arnis - Boys. The certificate contains spaces to record physical examination findings for school/intramural district meets, division meets, regional meets, and the Palarong Pambansa, to be filled out and signed by a physician. It confirms that the examinee is medically cleared to participate in school sporting events up to the national level competition.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    6 views1 page

    Medical For Coaches Asst Coaches Chaperones - v2023

    Uploaded by

    mark joseph quicho
    This medical certificate certifies that Marites L. Painaga, a 57 year old female, was examined on January 12, 2012 and found to be physically fit to participate in lower meets up to the Palarong Pambansa for the event of Arnis - Boys. The certificate contains spaces to record physical examination findings for school/intramural district meets, division meets, regional meets, and the Palarong Pambansa, to be filled out and signed by a physician. It confirms that the examinee is medically cleared to participate in school sporting events up to the national level competition.

    Copyright:

    © All Rights Reserved
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    of 1

    Revised as of April 2023

    Republic of the Philippines MCForm - 3


    DEPARTMENT OF EDUCATION
    CARAGA REGION
    (Region)
    BUTUAN CITY DIVISION
    (Division)
    BUTUAN CENTRAL ELEM. SCHOOL
    (School)
    AD.CURATO ST. BUTUAN CITY
    (School Address)

    MEDICAL CERTIFICATE
    (COACHES, ASSISTANT COACHES, CHAPERONE)

    01-12-2012
    __________________
    (Date)
    To Whom It May Concern:
    MARITES L. PAINAGA
    This is to certify that I have personally examined ____________________________
    Name
    57 sex _____
    age ______ F 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.

    ARNIS - BOYS
    Event: ___________________________

    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
    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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