Republic of the Philippines

Department of Education
Region XIII-CARAGA REGION
SCHOOLS DIVISION OF SURIGAO DEL SUR
GAMUT NATIONAL HIGH SCHOOL
Gamut Barobo, Surigao del Sur
Enclosure No. 2 to Deped Order No. 34, s. 2019

PHYSICAL FITNESS TEST SCORE CARD

Name: Year Level:

Age: Section:

PART I: HEALTH RELATED FITNESS

A. BODY COMPOSITION: Body Mass Index (BMI)

Height (meters) Weight (Kilograms) BMI Classification

B. CARDIOVASCULAR ENDURANCE – 3 Minute Step Test

HEART RATE PER MINUTE

Before the Activity After the Activity

Interpretation:

C. STRENGTH: Push Up and Basic Plank

Push Up (Number of Push-ups) Basic Plank (Time)

Interpretation: Interpretation:

A. FLEXIBILITY: Zipper Test and Sit and Reach

Just Touch Touch (in cm.) Gap (in cm.)

Left Hand
Right Hand
Interpretation:

Sit and Reach (Score in centimeters)

FIRST TRY SECOND TRY BEST SCORE

Interpretation:

PART II: SKILL RELATED FITNESS

A. COORDINATION: Juggling (3 minutes time)

Score: Interpretation:
 B. AGILITY: HEXAGON AGILITY TEST

Clockwise (time) Counterclockwise (time) Average Interpretation

C. SPEED: 40 Meter Sprint

Time: Interpretation:

D. POWER: Standing Long Jump

First Trial Second Trial Best Score / Interpretation

E. BALANCE: Stork Balance Stand Test

Right Foot Left Foot

Time: Time:
Interpretation: Interpretation:

F. REACTION TIME: Drop Test

1ST Trial 2nd Trial 3rd Trial MIDDLE Score Interpretation