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BATANG PINOY 2023

04
MEDICAL CLEARANCE

PHYSICAL EXAMINATION

Height ___________________________ Weight ________________________

Temperature _____________________ Blood Pressure _________________

Pulse Rate, Resting ________________ Respiratory Rate_________________

Other remarks:___________________________________________________________________

__________________________________________________________________________________

I hereby certify that ___________________________________________ underwent medical


(Full name of athlete)

check-up on _____________________ at ______________________________________________


(Date) (Address)

and was diagnosed FIT TO COMPETE in BATANG PINOY 2023.

Physician/Medical Officer
(Signature over printed name)

License No. ________________________


PTR: ______________________________
Date:______________________________

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