PHYSICAL FITNESS TEST INDIVIDUAL FORM

Name Age Sex Male

Last Name First Name Middle Name Female

Year & Name of Teacher MARIANE D. NAGUIT S.Y. 2021-2022 Birth Date
Section mm/dd/yyyy
School Bataan National High School School Address Roman Hi - way, Balanga City, Bataan Contact No.

Score Classification Body Mass Index BMI Standards/ Classification

Components Physical Fitness Test Units Pre Post Eg. 55kg/(1.45m)(1.45) Below 18.5 Underweight
A. Body 1. Weight kg 50/2.10 m 2 = 23. 81 18.5 - 24.9 Normal
Part I. Health Related

Composition 2. Height cm 25.0 - 29.9 Overweight

Classification (pts. Check) 30.0 - 44.9 Obese
3. BMI
B. Cardiovascular 4. 3 Minute Heart Rate ( ) Underweight ( ) Underweight 45 Above Extreme Obese
Fitness Test

Before Act

Endurance Step Test Per Minute After Act ( ) Normal ( ) Normal

5. Push - up Repetition ( ) Overweight ( ) Overweight
C. Strength
6. Basic Plank Time ( ) Obese ( ) Obese
7. Zipper Right Overlap cm ( ) Extreme ( ) Extreme
Test Left Overlap cm Obese Obese
D. Flexibility 1st Trial cm

8. Sit and Reach 2nd Trial cm Evaluation

Best Score cm

A. Coordination 9. Juggling Repetition Pre :

Clockwise Time
10. Hexagon
Counter Date Taken
Part II. Skills - Related

B. Agility Time
Agility Clockwise
Test Average Time Post
Fitness Test

C. Speed 11. 40 Meter Sprint Time

12. Standing 1st Trial cm Date Taken

D. Power Long Jump 2nd Trial cm Recommendation
Best Score cm Best Test Result Score Sports
13. Stork Balance Right Foot Time 1
E. Balance
Stand Test Left Foot Time 2
14. Stick 1st Trial cm 3
Drop 2nd Trial cm 4
F. Reaction Time
Test 3rd Trial cm ( continue in separate sheet if needed)
Middle Score cm
 PHYSICAL FITNESS TEST INDIVIDUAL FORM

Name Age Sex Male

Last Name First Name Middle Name Female

Year & Name of Teacher S.Y 2016 - 2017 Birth Date

Section mm/dd/yyyy

School Bataan National High School School Address Roman Hi - way, Balanga City, Bataan Contact No.

Components Physical Fitness Test Score Classification Body Mass Index BMI Standards/ Classification

Units 1st 2nd 3rd 4th Eg. 55kg/(1.45m)(1.45) Below 18.5 Underweight
1. Weight kg 50/2.10 m 2 = 23. 81 18.5 - 24.9 Normal
Part I. Health Related

A. Body Composition 2. Height cm 25.0 - 29.9 Overweight

Classification (pts. Check) 30.0 - 44.9 Obese
3. BMI
B. Cardio Vascular 4. 3 Minute Heart Rate ( ) Underweight ( ) Underweight 45 Above Extreme Obese
Fitness Test

Before Act

Endurance Step Test Per Minute After Act ( ) Normal ( ) Normal

5. Push - up Repetition ( ) Overweight ( ) Overweight
C. Strenght ( ) Obese ( ) Obese
6. Basic Plank Time

7. Zipper Right Overlap cm ( ) Extreme ( ) Extreme

Test Left Overlap cm Obese Obese

D. Flexibility 1st Trial cm

8. Sit and Reach 2nd Trial cm Evaluation

3rd Trial cm 1st
A. Coordination 9. Juggling Repetition Date Taken
Clockwise Time 2nd
10. Hexagon
Part II. Skills - Related

Counter Date Taken

B. Agility Time
Agility Clockwise 3rd
Test
Fitness Test

Average Time Date Taken

C. Speed 11. 40 Meter Sprint Time 4th
12. Standing 1st Trial cm
Date Taken
D. Power
Long Jump 2nd Trial cm
Recommendation
13. Stork Balance Right Foot Time
Best Test Result Score Sports
E. Balance
Stand Test Left Foot Time
1
13. Stick 1st Trial cm
2
F. Reaction
Drop 2nd Trial cm
3
Test 3rd Trial cm
Time 4
Middle Score cm
( continue in separate sheet if needed)