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    Department of Education – Schools Division Office of Laguna

    Document Title SGOD-SH-MNS-FO-19-


    Document No. 020
    Revision No. 0
    MEDICAL EXAMINATION MASTERLIST Effectivity
    September 06 , 2019
    OF SPORTS EVENT Date
    Page No. 1 of 1

    District:__CAVINTI Date: SEPTEMBER 27,2024


    School: LUMOT NATIONAL HIGH SCHOOL_ Sports Focal Person:_NINA RICCI G. DELOS
    SANTOS

    __SECONDARY___
    (LEVEL)
    SY:__ _2024-2025__

    NO. Name of Participant Name of Sports Fit Unfi Remarks


    Event to t to
    Pla Play
    y
    1 DENE JASLY B. CARDINAL BASKETBALL
    2 LAIKA V. RODRIGUEZ BASKETBALL
    3 CHRIZELLE A. QIURINO BASKETBALL
    4 ALLYSA CATE B. DIZON BASKETBALL
    5 KAYESHA MAE GORDULA BASKETBALL
    6 WILMA V. BEO BASKETBALL
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20
    21
    22
    23
    24
    25

    Prepared by:

    ______________________________
    Nurse II

    Noted:

    _______________________________
    Medical Officer III

    Registration Mark: Distribution Mark:


    This document is updated and controlled if it
    bears the red “CONTROLLED COPY” stamp.
    Otherwise, please refer to the Control of Documents
    & Records (CDR) for your updated copy.

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