PENGURUS KABUPATEN

PERSATUAN BOLA BASKET SELURUH INDONESIA

GUNUNGKIDUL
Sekretariat : Jl. Nusantara, Ledoksari, Wonosari, Gunungkidul 55813

Competition : ___________________________ Date : _____________ Time : _________ Referee : __________________________

Game No. : ________ Place : ________________________________________________ Umpire : __________________________
Team A : ________________________________________________ RUNNING SCORE
Time-out Team fouls A B A B A B
1 2 Period 1 1 2 3 4 2 1 2 3 4 1 1 41 41 81 81
3 4 Period 3 1 2 3 4 4 1 2 3 4 2 2 42 42 82 82
Extra periods 3 3 43 43 83 83
Licence Back Player
Fouls 4 4 44 44 84 84
Players
No. No in
1 2 3 4 5 5 5 45 45 85 85
1 6 6 46 46 86 86
2 7 7 47 47 87 87
3 8 8 48 48 88 88
4 9 9 49 49 89 89
5 10 10 50 50 90 90
6 11 11 51 51 91 91
7 12 12 52 52 92 92
8 13 13 53 53 93 93
9 14 14 54 54 94 94
10 15 15 55 55 95 95
11 16 16 56 56 96 96
12 17 17 57 57 97 97
Coach : 18 18 58 58 98 98
Coach Assistant : 19 19 59 59 99 99
Team B : ________________________________________________ 20 20 60 60 100 100
Time-out Team fouls 21 21 61 61 101 101
1 2 Period 1 1 2 3 4 2 1 2 3 4 22 22 62 62 102 102
3 4 Period 3 1 2 3 4 4 1 2 3 4 23 23 63 63 103 103
Extra periods 24 24 64 64 104 104
Licence Back Player
Fouls 25 25 65 65 105 105
Players
No. No. in
1 2 3 4 5 26 26 66 66 106 106
1 27 27 67 67 107 107
2 28 28 68 68 108 108
3 29 29 69 69 109 109
4 30 30 70 70 110 110
5 31 31 71 71 111 111
6 32 32 72 72 112 112
7 33 33 73 73 113 113
8 34 34 74 74 114 114
9 35 35 75 75 115 115
10 36 36 76 76 116 116
11 37 37 77 77 117 117
12 38 38 78 78 118 118
Coach : 39 39 79 79 119 119
Coach Assistant : 40 40 80 80 120 120
Scores : Period 1 A ________ B ________ 2 A ________ B ________
Final score Team A ______ Team B ______
Scores : Period 3 A ________ B ________ 4 A ________ B ________
Scores : Extra Periods A ________ B ________ Name of winning team : __________________________

Scorekeeper : ________________________________________ Referee : ______________________________

Timekeeper : ________________________________________ Umpire : ______________________________
24” Operator : ________________________________________ Captain’s signature in case of protest : _______________
 PEMERINTAH KABUPATEN GUNUNGKIDUL
DINAS PENDIDIKAN, PEMUDA & OLAHRAGA
Jalan Pemuda No. 32 Baleharjo Wonosari 55801 Kotak Pos 135 Telepon (0274) 391191

Competition : ___________________________ Date : _____________ Time : _________ Referee : __________________________

Game No. : ________ Place : ________________________________________________ Umpire : __________________________
Team A : ________________________________________________ RUNNING SCORE
Time-out Team fouls A B A B A B
1 2 Period 1 1 2 3 4 2 1 2 3 4 1 1 41 41 81 81
3 4 Period 3 1 2 3 4 4 1 2 3 4 2 2 42 42 82 82
Extra periods 3 3 43 43 83 83
Licence Back Player
Fouls 4 4 44 44 84 84
Players
No. No in
1 2 3 4 5 5 5 45 45 85 85
1 6 6 46 46 86 86
2 7 7 47 47 87 87
3 8 8 48 48 88 88
4 9 9 49 49 89 89
5 10 10 50 50 90 90
6 11 11 51 51 91 91
7 12 12 52 52 92 92
8 13 13 53 53 93 93
9 14 14 54 54 94 94
10 15 15 55 55 95 95
11 16 16 56 56 96 96
12 17 17 57 57 97 97
Coach : 18 18 58 58 98 98
Coach Assistant : 19 19 59 59 99 99
Team B : ________________________________________________ 20 20 60 60 100 100
Time-out Team fouls 21 21 61 61 101 101
1 2 Period 1 1 2 3 4 2 1 2 3 4 22 22 62 62 102 102
3 4 Period 3 1 2 3 4 4 1 2 3 4 23 23 63 63 103 103
Extra periods 24 24 64 64 104 104
Licence Back Player
Fouls 25 25 65 65 105 105
Players
No. No. in
1 2 3 4 5 26 26 66 66 106 106
1 27 27 67 67 107 107
2 28 28 68 68 108 108
3 29 29 69 69 109 109
4 30 30 70 70 110 110
5 31 31 71 71 111 111
6 32 32 72 72 112 112
7 33 33 73 73 113 113
8 34 34 74 74 114 114
9 35 35 75 75 115 115
10 36 36 76 76 116 116
11 37 37 77 77 117 117
12 38 38 78 78 118 118
Coach : 39 39 79 79 119 119
Coach Assistant : 40 40 80 80 120 120
Scores : Period 1 A ________ B ________ 2 A ________ B ________
Final score Team A ______ Team B ______
Scores : Period 3 A ________ B ________ 4 A ________ B ________
Scores : Extra Periods A ________ B ________ Name of winning team : __________________________

Scorekeeper : ________________________________________ Referee : ______________________________

Timekeeper : ________________________________________ Umpire : ______________________________
24” Operator : ________________________________________ Captain’s signature in case of protest : _______________