DON HONORIO VENTURA STATE UNIVERSITY

Villa de Bacolor, Pampanga

INSTITUTE OF PHYSICAL EDUCATION

PHYSICAL FITNESS SCORE CARD

As you perform various pre-assessment of health-related fitness, it is important that you keep your performance on
record. Fill-out this score card with the results of your physical fitness tests.
LAST NAME UBALDO FIRST NAME AIDA M.I M

AGE 19 SEX F PE CODE PATHFIT 3 Course/Yr/Sec BSA-2G

MENU OF DANCE, SPORTS, MARTIAL ARTS, GROUP

DATE OF BIRTH (MM/DD/YYYY) 08/23/2001 PE TITTLE EXERCISE, OUTDOOR AND ADVENTURE ACTIVITIES

INSTRUCTOR’S
SEM FIRST S.Y. 2020-2021 LYNDO V. FONTANILLA, LPT, MAEd (c)
NAME
PRE-TEST POST TEST
HEALTH-RELATED FITNESS HEALTH-RELATED FITNESS
ANTHROPOMETRY AND BODY COMPOSITION ANTHROPOMETRY AND BODY COMPOSITION
I. Body Mass Index I. Body Mass Index
Weight (kg) 60 KG Height (m) 1.65 Weight (kg) Height (m)
60 BMI CATEGORY BMI CATEGORY
BMI = weight (kg) 1.652 22.03KG/M2 BMI = weight (kg)
height (m)2 NORMAL RANGE height (m)2

II. Waist to Hip Ratio II. Waist to Hip Ratio

Waist (inches) Hip Score Rating Points Waist (inches) Hip Score Rating Points
39 0.76 GOOD
III. Waist Circumference III. Waist Circumference
Waist (inches) Rating Points Waist (inches) Rating Points
30 INCHES LOW 5
MOBILITY TEST MOBILITY TEST
Right Left Rating Points Right Left Rating Points
Trunk Rotation Trunk Rotation
GOO GOO
Flexibility Test 15 15 4 4 Flexibility Test
D D
Score Rating Points Score Rating Points
Wall-Sit Test 37 AVERAGE 3 Wall-Sit Test
CARDIORESPIRATORY FITNESS CARDIORESPIRATORY FITNESS
3-min Step Test RHR WHR Classification 3-min Step Test RHR WHR Classification
(bpm) 78 78 GOOD (bpm)
MUSCULOSKELETAL FITNESS MUSCULOSKELETAL FITNESS
Score Rating Points Score Rating Points
Push-ups Push-ups
13 AVERAGE 3
Score Rating Points Score Rating Points
Elbow Plank 30 BELOW 2 Elbow Plank
AVERAGE
SKILLS-RELATED FITNESS SKILLS-RELATED FITNESS
AGILITY TEST AGILITY TEST
Score (sec) Rating Points Score (sec) Rating Points
Illinois Agility Test Illinois Agility Test
17 EXCELLENT 5
BALANCE TEST BALANCE TEST
Score (sec) Rating Points Score (sec) Rating Points
Stork Balance Test Stork Balance Test
15 15 FAIR 2 2
COORDINATION TEST COORDINATION TEST
Alternate Hand- Score (sec) Rating Points Alternate Hand-Wall Score (sec) Rating Points
Wall Toss Test 35 GOOD 4 Toss Test
Accomplished by:

AIDA M. UBALDO NOVEMBER 6, 2020

Student’s Printed Name Date Accomplished

Noted:

LYNDO V. FONTANILLA, LPT, MAEd (c)

Instructor