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    Medical Certificate For Athletes

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    Caitlin Peñera
    This medical certificate from the Department of Education of Baguio City certifies that a student was examined and found physically fit or unfit to participate in school sports competitions from intramurals up to the national Palarong Pambansa games. The certificate documents the student's personal details, physical examination findings for different body systems, and fitness determination for various levels of competition signed by the examining physician.

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    © All Rights Reserved
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    Medical Certificate For Athletes

    Uploaded by

    Caitlin Peñera
    88 views2 pages
    This medical certificate from the Department of Education of Baguio City certifies that a student was examined and found physically fit or unfit to participate in school sports competitions from intramurals up to the national Palarong Pambansa games. The certificate documents the student's personal details, physical examination findings for different body systems, and fitness determination for various levels of competition signed by the examining physician.

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    Medical Certificate for Athletes (2)

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    This medical certificate from the Department of Education of Baguio City certifies that a student was examined and found physically fit or unfit to participate in school sports competitions from intramurals up to the national Palarong Pambansa games. The certificate documents the student's personal details, physical examination findings for different body systems, and fitness determination for various levels of competition signed by the examining physician.

    Copyright:

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

    Medical Certificate For Athletes

    Uploaded by

    Caitlin Peñera
    This medical certificate from the Department of Education of Baguio City certifies that a student was examined and found physically fit or unfit to participate in school sports competitions from intramurals up to the national Palarong Pambansa games. The certificate documents the student's personal details, physical examination findings for different body systems, and fitness determination for various levels of competition signed by the examining physician.

    Copyright:

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

    Republic of the Philippines MCForm - 1

    Revised as of September 26, 2019 DEPARTMENT OF EDUCATION


    Cordillera Administrative Region
    SCHOOLS DIVISION OF BAGUIO CITY
    ______________________________
    (SCHOOL)
    ______________________________
    (School Address)

    MEDICAL CERTIFICATE

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


    Republic of the Philippines MCForm - 1
    DEPARTMENT OF EDUCATION
    Cordillera Administrative Region
    SCHOOLS DIVISION OF BAGUIO CITY
    School/Intrams/District Meet
    ______________________________ Remarks/Findings:
    To Whom It May Concern: (SCHOOL)
    _____________________________ Ht ._______cm FIT
    ______________________________
    (School Address) Physician/Medical Officer Wt:_______kg
    This is to certify that I have personally examined ___________________ (signature over printed name) BP.____________mmHg UNFIT
    Name
    PRC PR:____________bpm
    age ____ sex _____ and have found that he/she is physically fit unfit, LICENSE: PTR NO. RR:____________cpm Date:
    during the time of examination, to join and participate in the lower meets up to Unit/Division Meet Remarks/Findings:

    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)

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