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    Medical For Athletes 1 - Revised

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    RanDave TV
    This medical certificate certifies that a student was examined and found physically fit or unfit to participate in sports competitions of increasing levels, from school to regional meets. The certificate lists the student's physical examination results for eyes, ears, cardiovascular system, and other areas. If deemed fit, the student's height, weight, blood pressure, and other vital signs are recorded for each meet level by the examining physician.

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    © All Rights Reserved
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    Medical For Athletes 1 - Revised

    Uploaded by

    RanDave TV
    12 views2 pages
    This medical certificate certifies that a student was examined and found physically fit or unfit to participate in sports competitions of increasing levels, from school to regional meets. The certificate lists the student's physical examination results for eyes, ears, cardiovascular system, and other areas. If deemed fit, the student's height, weight, blood pressure, and other vital signs are recorded for each meet level by the examining physician.

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    4. Medical for Athletes 1- Revised.docx

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    This medical certificate certifies that a student was examined and found physically fit or unfit to participate in sports competitions of increasing levels, from school to regional meets. The certificate lists the student's physical examination results for eyes, ears, cardiovascular system, and other areas. If deemed fit, the student's height, weight, blood pressure, and other vital signs are recorded for each meet level by the examining physician.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    12 views2 pages

    Medical For Athletes 1 - Revised

    Uploaded by

    RanDave TV
    This medical certificate certifies that a student was examined and found physically fit or unfit to participate in sports competitions of increasing levels, from school to regional meets. The certificate lists the student's physical examination results for eyes, ears, cardiovascular system, and other areas. If deemed fit, the student's height, weight, blood pressure, and other vital signs are recorded for each meet level by the examining physician.

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    Republic of the Philippines MCForm - 1

    Revised as of September 26, 2019

    DEPARTMENT OF EDUCATION

    XI

    (REGION)

    PANABO CITY

    (DIVISION)

    ______________________________

    M E D I C A L C(SCHOOL)
    ERTIFICATE

    To Whom It May Concern: ______________________________

    This is to certify that I have personally examined ___________________ age ____ sex _____ 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: ___________________________

    Physical Examination

    School/Intrams/District Meet Unit/Division Meet Regional Meet Palarong Pambansa

    Normal Normal Normal Normal

    1. Eyes YES | NO YES | NO YES | NO YES | NO

    2. Ears, Nose, Throat YES | NO YES | NO YES | NO YES | NO

    3. Mouth and Teeth YES | NO YES | NO YES | NO YES | NO

    4. Neck YES | NO YES | NO YES | NO YES | NO

    5. Cardiovascular YES | NO YES | NO YES | NO YES | NO

    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 (reflexes) YES | NO YES | NO YES | NO YES | NO

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


    Republic of the Philippines MCForm - 1

    DEPARTMENT OF EDUCATION

    XI

    (REGION)

    PANABO CITY

    (DIVISION)

    ______________________________

    (SCHOOL)

    ______________________________

    School/Intrams/District Meet Remarks/Findings: FIT

    UNFIT

    _____________________________ Physician/Medical Officer Ht ._______cm Wt:_______kg Date:

    (signature over printed name) BP.____________mmHg

    PRC PR:____________bpm

    LICENSE: PTR NO. RR:____________cpm

    Unit/Division Meet Remarks/Findings: FIT

    UNFIT

    _____________________________Physician/Medical Officer Ht ._______cm Wt:_______kg Date:

    (signature over printed name) BP.____________mmHg

    PRC PR:____________bpm

    LICENSE: PTR NO. RR:____________cpm

    Regional Meet Remarks/Findings: FIT

    UNFIT

    _____________________________Physician/Medical Officer Ht ._______cm Wt:_______kg Date:

    (signature over printed name) BP.____________mmHg

    PRC PR:____________bpm

    LICENSE: PTR NO. RR:____________cpm

    Palarong Pambansa Remarks/Findings: FIT

    UNFIT

    _____________________________ Physician/Medical Officer Ht ._______cm Wt:_______kg Date:

    (signature over printed name) BP.____________mmHg

    PRC PR:____________bpm

    LICENSE: PTR NO. RR:____________cpm

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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