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  • Department of Education: Medical Certificate Abnormalities

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    Mike Perez
    18 Ansichten1 Seite
    This medical certificate documents the medical examination of an athlete. It contains sections to record the results of examining the athlete's mental status, head, eyes, ears, nose, mouth, neck, chest, heart, lungs, abdomen, genitals, upper and lower limbs, and neurological system. It also documents whether the athlete has had any concussions in the past year and the results of medical exams following concussions. Any abnormalities are to be noted. Sections also address the athlete's asthma, allergies, and medications. The certificate concludes with the physician certifying whether the athlete is fit to compete and includes the name of the athlete, examining physician, physician's license number, and date.

    Originalbeschreibung:

    Palaro Medical Certificate

    Originaltitel

    Medical Cert.

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    This medical certificate documents the medical examination of an athlete. It contains sections to record the results of examining the athlete's mental status, head, eyes, ears, nose, mouth, neck, chest, heart, lungs, abdomen, genitals, upper and lower limbs, and neurological system. It also documents whether the athlete has had any concussions in the past year and the results of medical exams following concussions. Any abnormalities are to be noted. Sections also address the athlete's asthma, allergies, and medications. The certificate concludes with the physician certifying whether the athlete is fit to compete and includes the name of the athlete, examining physician, physician's license number, and date.

    Copyright:

    © All Rights Reserved
    Als PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    18 Ansichten1 Seite

    Department of Education: Medical Certificate Abnormalities

    Hochgeladen von

    Mike Perez
    This medical certificate documents the medical examination of an athlete. It contains sections to record the results of examining the athlete's mental status, head, eyes, ears, nose, mouth, neck, chest, heart, lungs, abdomen, genitals, upper and lower limbs, and neurological system. It also documents whether the athlete has had any concussions in the past year and the results of medical exams following concussions. Any abnormalities are to be noted. Sections also address the athlete's asthma, allergies, and medications. The certificate concludes with the physician certifying whether the athlete is fit to compete and includes the name of the athlete, examining physician, physician's license number, and date.

    Copyright:

    © All Rights Reserved
    Als PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 1

    Republic of the Philippines

    DEPARTMENT OF EDUCATION
    ________________________
    (Region)

    ______________________________
    (Division)

    ______________________________
    (School)

    ______________________________
    (School Address)

    MEDICAL CERTIFICATE

    ABNORMALITIES

    If Athlete had a Concussion in

    Medical Examination following post

    the past year please cetify that:

    period after Concusion was normal

    Normal

    Abnormal

    Normal

    Abnormal

    (record)

    Normal

    Abnormal

    Mouth, teeth, throat, nose

    Normal

    Abnormal

    Temporomandibular joint

    Normal

    Abnomal

    Neck

    Cervical spine, lymph nodes

    Normal

    Abnomal

    Chest

    Breath sounds, rib


    Normal

    Abnormal

    Normal

    Abnormal

    Normal

    Abnormal

    Normal

    Abnormal

    Athlete Fit to Box

    General Medical Exam

    List

    abnormalities

    not

    covered

    in

    specific system exams below:


    Mental Status/ Psychological
    Briet survey
    Cranial nerves, eyes, pupil size and
    Head

    reactivity.

    Fundi,

    Vision

    by

    chart

    tenderness on compession
    Pulse/ blood pressure
    (record)
    Cardio Vascular System

    Heart examination: sounds, murmurs,


    heaves, size, rhythm
    Upper

    Ortopedic System

    limb:

    shoulder

    wrist,

    fingers

    hand,

    Lower limb: (ankle, knee, hip

    Neuclogical System

    Normal

    Abnormal

    Relaxes

    Normal

    Abnormal

    Vorbal reponses

    Normal

    Abnormal

    Motor responses and balance

    Normal

    Abnormal

    Asthma

    (record)

    Allergies

    Type of reaction (record)

    Medications used

    Name and dosage (record)


    Any TUE Submitted?

    NO

    Yes

    No

    Yes

    No

    YES (If YES, Please explain)


    Name of Athlete____________________________________
    Name of MD________________________________________

    Lic. Number:______________________
    Date:______________________

    FOR PALARONG PAMBANSA ONLY

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