COPYRIGHT
NOT
RESERVED
TO BE REPRODUCED SCORE-SHEET
NO
DR. C. M. BHATIA'S
BATTERY OF PERFORMANCE TESTS OF INTELLIGENCE
Name of Subject, M.S,
Place:
Father'sName
Date 07/02 2024
Time
Lpm-2 pm
Date of Birth of Subject from official records 15/09/2005
Estimate age of the Subject. 22 Years
Whether (If
literate or Iliterate Literat (furminy MSc clinNea
literate class in
which he is reading or has read)
Father's occupation(or subjects occupation) Caste
General opinion about the subject's intelligence OVery Superior OSuperior
(If reading in school, position in class) OAverage O Inferior oVery inferior
Any particular emotional tendency noticed during the test:
TEST I- KOHS BLOCK DESIGN TEST
Design No. Time taken in mts. & Seconds Success or failure Any remarks
1. (Practice) 6 ec. Succes 2
2 Succes 2
3 2 min. Fadure
4 Imin llseC. Success
2
17 2ec. Sueces
6 3 min Fadere
46 nec. Success
Imun. 36 2ec. Success
9 2 in.49 2ec. Succes
10 3 min. Failure
TEST II -PASSALONG TEST
Time taken in mts. & Seconds Success or failure Any remarks
Design No.
1(Practice) 7 sec. Succes
2 Succes 2
3 39 ec. Succes 2
4 25 2c. Success
43 2ec. Success
6 22 22c. Success 3
Imin. 37 ec. Succes 2
3 n. Failure
[ P.T.O)
TEST III-PATTERN DRAWING TEST
Design No. Time taken in mts. & Seconds Success or failure Any remarks
1(Practice) 5 ec Succes 2
2
Success
3
Succes
22 nec.
Succes
5 3 min. Faiure
6 3 min. Foilure
TEST IV - IMMEDIATE MEMORY TEST
Span
For Sounds 8 For Digits
For Reversed Digits
6
For Reversed Sounds 6
TEST V-PICTURE CONSTRUCTION TEST
Time taken in mts. & Seconds Success or failure Any remarks
Design No.
Suceess 2
1(Practice)
Success
9 gec
2
Success
3
49 sec. Success
4
Fadre
5
onn. 24 ec 2(2 pieeopu one)
(Signature of Examiner)
