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    Medical For Athletes 1 1

    Uploaded by

    Lloyd Benitez De Guzman
    This medical certificate certifies that Lyra Mie D. Condes was physically examined and found fit to participate in volleyball for girls in school sports competitions including lower meets, unit/division meets, regional meets, and Palarong Pambansa. The certificate documents the results of the physical examination checking eyes, ears, mouth, cardiovascular system, lungs, abdomen, skin, musculoskeletal system and more. The physician certified the student was fit based on measurements of height, weight, and vital signs.

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    © All Rights Reserved
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    Medical For Athletes 1 1

    Uploaded by

    Lloyd Benitez De Guzman
    15 views1 page
    This medical certificate certifies that Lyra Mie D. Condes was physically examined and found fit to participate in volleyball for girls in school sports competitions including lower meets, unit/division meets, regional meets, and Palarong Pambansa. The certificate documents the results of the physical examination checking eyes, ears, mouth, cardiovascular system, lungs, abdomen, skin, musculoskeletal system and more. The physician certified the student was fit based on measurements of height, weight, and vital signs.

    Original Description:

    Medical Athletes form.

    Original Title

    4. Medical for Athletes 1 1

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    © © All Rights Reserved

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    This medical certificate certifies that Lyra Mie D. Condes was physically examined and found fit to participate in volleyball for girls in school sports competitions including lower meets, unit/division meets, regional meets, and Palarong Pambansa. The certificate documents the results of the physical examination checking eyes, ears, mouth, cardiovascular system, lungs, abdomen, skin, musculoskeletal system and more. The physician certified the student was fit based on measurements of height, weight, and vital signs.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    15 views1 page

    Medical For Athletes 1 1

    Uploaded by

    Lloyd Benitez De Guzman
    This medical certificate certifies that Lyra Mie D. Condes was physically examined and found fit to participate in volleyball for girls in school sports competitions including lower meets, unit/division meets, regional meets, and Palarong Pambansa. The certificate documents the results of the physical examination checking eyes, ears, mouth, cardiovascular system, lungs, abdomen, skin, musculoskeletal system and more. The physician certified the student was fit based on measurements of height, weight, and vital signs.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Revised as of September 26, 2019 Republic of the Philippines MCForm - 1

    DEPARTMENT OF EDUCATION
    MIMAROPA
    (REGION)
    PUERTO PRINCESA CITY
    (DIVISION)
    ______________________________
    SICSICAN NATIONAL
    (SCHOOL) HIGH SCHOOL
    ______________________________
    Purok Mahogany, Bgy. Sicsican, Puerto Princesa City
    (School Address)

    M E D I CAL C E RT I FI CAT E

    To Whom It May Concern: g. knees YES | NO YES | NO YES | NO YES | NO


    h. ankles YES | NO YES | NO YES | NO YES | NO
    LYRA MIE D. CONDESA age
    This is to certify that I have personally examined _______________________ i. feet YES | NO YES | NO YES | NO YES | NO
    Name
    16 F 11. Neuromuscular
    _____ sex _____ and have found that he/she is physically fit unfit, during the YES | NO YES | NO YES | NO YES | NO
    (reflexes)
    time of examination, to join and participate in the lower meets up to Palarong Pambansa.
    School/Intrams/District Meet Remarks/Findings:
    VOLLEYBALL GIRLS
    Event: ___________________________
    _____________________________ Ht ._______cm FIT
    Physician/Medical Officer Wt:_______kg
    Physical Examination (signature over printed name) BP.____________mmHg UNFIT
    PRC PR:____________bpm
    School/Intrams/ Unit/Division Regional Palarong LICENSE: PTR NO. RR:____________cpm Date:
    District Meet Meet Meet Pambansa Unit/Division Meet Remarks/Findings:
    Normal Normal Normal Normal
    _____________________________ Ht ._______cm FIT
    1. Eyes YES | NO YES | NO YES | NO YES | NO Physician/Medical Officer Wt:_______kg
    2. Ears, Nose, Throat YES | NO YES | NO YES | NO YES | NO (signature over printed name) BP.____________mmHg UNFIT
    3. Mouth and Teeth YES | NO YES | NO YES | NO YES | NO PRC PR:____________bpm
    4. Neck YES | NO YES | NO YES | NO YES | NO LICENSE: PTR NO. RR:____________cpm Date:
    Regional Meet Remarks/Findings:
    5. Cardiovascular YES | NO YES | NO YES | NO YES | NO
    6. Chest and Lungs YES | NO YES | NO YES | NO YES | NO _____________________________ Ht ._______cm FIT
    7. Abdomen YES | NO YES | NO YES | NO YES | NO Physician/Medical Officer Wt:_______kg
    8. Skin YES | NO YES | NO YES | NO YES | NO (signature over printed name) BP.____________mmHg UNFIT
    PRC PR:____________bpm
    9. Genitalia-Hernia (male) YES | NO YES | NO YES | NO YES | NO LICENSE: PTR NO. RR:____________cpm Date:
    10. Muskuloskeletal: ROM YES | NO YES | NO YES | NO YES | NO Palarong Pambansa Remarks/Findings:
    a. neck YES | NO YES | NO YES | NO YES | NO
    b. spine YES | NO YES | NO YES | NO YES | NO _____________________________ Ht ._______cm FIT
    Physician/Medical Officer Wt:_______kg
    c. shoulder YES | NO YES | NO YES | NO YES | NO (signature over printed name) BP.____________mmHg UNFIT
    d. arms/hands YES | NO YES | NO YES | NO YES | NO PRC PR:____________bpm
    e. hips YES | NO YES | NO YES | NO YES | NO LICENSE: PTR NO. RR:____________cpm Date:
    f. thighs YES | NO YES | NO YES | NO YES | NO

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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