Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 6
REGIONAL LEARNING AND DOCTRINE DEVELOPMENT DIVISION
Camp Gen Martin Teofilo B Delgado, Fort San Pedro, Iloilo City
Email Address: [Link]@[Link]
Revised Form: 01-2020 (Form for 50 years old & below only) Running #: ________
(Fill-up this form properly! Incomplete Data, No PFT Results) Registration #_________________
Date Taken: _
Steps: PNP ID #: _ _ _____
1. Registration: __________________________
PFT: CY 2024
(Secretariat Name & Signature)
2. Measurement:
Height: _ ___ Weight: __ __ Waistline: _____ BMI: ___________________
Result: __________________ Weight to lose: __________
3. BP: 1st BP: _____________ 2nd BP: ________________ BMI Category: ___________
4. ECG: __________________________________________ Score: _________________
5. GO / No GO: __________________________________
(Physician Name & Signature)
Full Name: Last Name, First Name, M.I. Rank Sex
Date of Birth: Age: PNP Badge Number:
Office: (Print Complete Office/Unit Assignment)
Events Raw Score Rating Member/Scorer’s Name Team Leader’s Name
& Signature (PNCO) & Signature (PCO)
Sit-up (1 minute)
Push-up (1 minute)
300 Meter Sprint
(for 34 years old & below only)
Kilometer Run
( ) 3k for 34 years old & below
( ) 2k for 35-44 years old
( ) 1k for 45 years old & above
TOTAL REMARKS:
OVERALL PFT RESULT:
______________________________ Noted: __________________________
(Performer’s Signature) Name & Signature
Over-all event Supervisor (RLDDD)
===================================================================
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 6
REGIONAL LEARNING AND DOCTRINE DEVELOPMENT DIVISION
Camp Gen Martin Teofilo B Delgado, Fort San Pedro, Iloilo City
Performer's Copy:
Email Address: [Link]@[Link]
Revised Form: 01-2020 (Form for 50 years old & below only)
(Fill-up this form properly! Incomplete Data, No PFT Results)
Running #:
Date Taken: D
_______
r
Full Name: Last Name, PFT: CY 2024 First Name,
PNP ID #: __
M.I. Rank
____
Sex
Date of Birth: Age: PNP Bdge Number:
Office: (Print Complete Office/Unit Assignment)
REMARKS: Control Number: __________________
OVERALL PFT RESULT:
______________________________
(Performer’s Signature) Noted: __________________________
Name & Signature
Over-all event Supervisor
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 6
REGIONAL LEARNING AND DOCTRINE DEVELOPMENT DIVISION
Camp Gen Martin Teofilo B Delgado, Fort San Pedro, Iloilo City
Email Address: [Link]@[Link]
Revised Form: 01-2020 (Form for 51 years old & above) Running #: ________
(Fill-up this form properly! Incomplete Data, No PFT Results) Registration #_________________
Date Taken: _
PNP ID #: _ _ _____
Steps:
1. Registration: __________________________ PFT: CY 2024
(Secretariat Name & Signature)
2. Measurement:
Height: _ ___ Weight: __ __ Waistline: _____ BMI: ___________________
Result: __________________ Weight to lose: __________
3. BP: 1st BP: _____________ 2nd BP: ________________ BMI Category: ___________
-
4. ECG: __________________________________________ Score: _________________
5. GO / No GO: __________________________________
(Physician Name & Signature)
Full Name: Last Name, First Name, M.I. Rank Sex
Date of Birth: Age: PNP Badge Number:
Office: (Print Complete Office/Unit Assignment)
Events Raw Score Rating Member/Scorer’s Name Team Leader’s Name
& Signature (PNCO) & Signature (PCO)
Stretching (10 minutes)
1.5 Kilometer Walk
TOTAL REMARKS:
OVERALL PFT RESULT:
______________________________ _________________________
(Performer’s Signature) Name & Signature
Over-all event Supervisor (RLDDD)
===================================================================
Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, POLICE REGIONAL OFFICE 6
REGIONAL LEARNING AND DOCTRINE DEVELOPMENT DIVISION
Performer's Copy:
Camp Gen Martin Teofilo B Delgado, Fort San Pedro, Iloilo City
Email Address: [Link]@[Link]
Revised Form: 01-2020 (Form for 51 years old & above) Running #: _______
(Fill-up this form properly! Incomplete Data, No PFT Results) Date Taken: D r
Full Name:
PFT: CY 2024
Last Name, First Name,
PNP ID #: __
M.I. Rank
____
Sex
Date of Birth: Age: PNP Badge Number:
Office: (Print Complete Office/Unit Assignment)
REMARKS: Control Number: __________________
OVERALL PFT RESULT:
Noted: __________________________
Name & Signature
_________________ Over-all event Supervisor
(Performer’s Signature)
