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Medical Certificate: To Whom It May Concern:, Daxx Raven L. Age

This medical certificate documents a physical examination of Luz Daxx Raven L. finding him physically fit to participate in badminton competitions from elementary school intramurals up to the Palarong Pambansa national games. The certificate lists the results of examinations of various body parts and systems and certifies the examinee is in normal health without any restrictions for each level of competition based on the physical demands.

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Robbie Rose Lava
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74 views2 pages

Medical Certificate: To Whom It May Concern:, Daxx Raven L. Age

This medical certificate documents a physical examination of Luz Daxx Raven L. finding him physically fit to participate in badminton competitions from elementary school intramurals up to the Palarong Pambansa national games. The certificate lists the results of examinations of various body parts and systems and certifies the examinee is in normal health without any restrictions for each level of competition based on the physical demands.

Uploaded by

Robbie Rose Lava
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Revised as of September 26,

2019

MEDICAL CERTIFICATE
b. spine YES | NO YES | NO YES | NO YES | NO
To Whom It May Concern: c. shoulder YES | NO YES | NO YES | NO YES | NO
d. arms/hands YES | NO YES | NO YES | NO YES | NO
This is to certify that I have personally examined LUZ , DAXX RAVEN L. age e. hips YES | NO YES | NO YES | NO YES | NO
Name
11 sex Male and have found that he/she is physically fit unfit, during the f. thighs YES | NO YES | NO YES | NO YES | NO
g. knees YES | NO YES | NO YES | NO YES | NO
time of examination, to join and participate in the lower meets up to Palarong
h. ankles YES | NO YES | NO YES | NO YES | NO
Pambansa. i. feet YES | NO YES | NO YES | NO YES | NO
11. Neuromuscular YES | NO YES | NO YES | NO YES | NO
(reflexes)
Event: Badminton (Boys) Elementary

Physical Examination School/Intrams/District Meet Remarks/Findings:

School/ Unit/Division Regional Palarong _____________________________ Ht ._______cm FIT


Intrams/District Meet Meet Pambansa Physician/Medical Officer Wt:_______kg
Meet (signature over printed name) BP.____________mmHg UNFIT
PRC PR:____________bpm
Normal Normal Normal Normal LICENSE: PTR NO. RR:____________cpm Date:
1. Eyes YES | NO YES | NO YES | NO YES | NO Unit/Division Meet/Provincial Meet Remarks/Findings:
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
4. Neck YES | NO YES | NO YES | NO YES | NO (signature over printed name) BP.____________mmHg UNFIT
5. Cardiovascular YES | NO YES | NO YES | NO YES | NO PRC PR:____________bpm
6. Chest and Lungs YES | NO YES | NO YES | NO YES | NO LICENSE: PTR NO. RR:____________cpm Date:
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

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


Regional Meet Remarks/Findings:

_____________________________ Ht ._______cm FIT


Physician/Medical Officer Wt:_______kg
(signature over printed name) BP.____________mmHg UNFIT
PRC PR:____________bpm
LICENSE: PTR NO. RR:____________cpm Date:
Palarong Pambansa Remarks/Findings:

_____________________________ Ht ._______cm FIT


Physician/Medical Officer Wt:_______kg
(signature over printed name) BP.____________mmHg UNFIT
PRC PR:____________bpm
LICENSE: PTR NO. RR:____________cpm Date:

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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