Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 5 views

    Medical For Athletes 1

    Uploaded by

    audreyvonespinosa30

    Copyright:

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

    Medical For Athletes 1

    Uploaded by

    audreyvonespinosa30
    5 views2 pages

    Original Title

    Medical for Athletes 1

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    5 views2 pages

    Medical For Athletes 1

    Uploaded by

    audreyvonespinosa30

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 2

    Republic of the Philippines MCForm - 1

    DEPARTMENT OF EDUCATION
    REGION 02 – CAGAYAN VALLEY
    (REGION)
    NUEVA VIZCAYA
    (DIVISION)
    SAINT LOUIS SCHOOL
    (SCHOOL)
    BRGY. POBLACION NORTH, SOLANO, NUEVA VIZCAYA
    (School Address)

    MEDICAL CERTIFICATE

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


    Republic of the Philippines MCForm - 1
    DEPARTMENT OF EDUCATION
    REGION 02 – CAGAYAN VALLEY
    (REGION)
    NUEVA VIZCAYA
    (DIVISION)
    School/Intrams/District Meet Remarks/Findings:
    To Whom It May Concern: SAINT LOUIS SCHOOL
    (SCHOOL) _____________________________ Ht ._______cm FIT
    BRGY. POBLACION NORTH, SOLANO, Physician/Medical
    NUEVA VIZCAYA Officer 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 LICENSE: PTR NO. RR:____________cpm Date:
    fit unfit, during the time of examination, to join and participate in the Unit/Division Meet Remarks/Findings:

    lower meets up to 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)

    You might also like