HEALTH AND ACTIVITY CARD
GENERAL INFORMATION
AADHAR CARD NO: …………………………………………………………….
NAME : …………………………………………………………………………...
ADMISSION NO: ………………………..DATE OF BIRTH….…/……/……….
M F T ……………………………….. BLOOD GROUP…………………………
MOTHER’S NAME : ……………………………………………………………..
YEAR OF BIRTH ……………………………….WEIGHT…………….……KG
HEIGHT…………………..FEET/CM BLOOD GROUP…………………………
AADHAR CARD NO: …………………………………………………………….
FATHER’S NAME : ……………………………………………………………..
YEAR OF BIRTH ……………………………….WEIGHT…………….……KG
HEIGHT…………………..FEET/CM BLOOD GROUP…………………………
AADHAR CARD NO: ……………………………………………………………..
FAMILY MONTHLY: ……………………………………………………………..
ADDRESS: …………………………………………………………………………
………………………………………………………………………………………
CONTACT NO. : (M)………………………………………………………………
CWSN , SPECIFY :………………………………………………………………...
SIGNATURE OF PARENTS/ GUARDIAN DATE
HEALTH AND PHYSICAL EDUCATION 12
HEALTH AND ACTIVITY RECORD
Components Parameters Class 9th Class 10th Class 11th Class 12
th
Vision RE/ LE
Ears Left/ Right
Teeth Occlusion Caries/ Tonsils/ Gums
General Body Height
Measurements
Weight
Circumferences Hip
Waist
Health Status Pulse
Blood Pressure
Posture Evaluation If any:
Head Forward/ Sunken Chest/ Round
Shoulders/ Kyphosis/ Lordosis/ Abdominal
Ptosis/ Body Lean/ Tilted Head/ Shoulders
Uneven/ Scoliosis/ Flat Feet/ Knock
Knees/ Bow Legs
Strand 1:
Any one of following:
Sporting Activities 1. Athletics/ Swimming
(HPE) 2. Team Game
(For details, see HPE 3. Individual Game
manual 4. Adventure Sports
available on CBSE
Strand 2:
website
www.cbseacademic.in) Health and Fitness
(Mass PT, Yoga, Dance, Calisthenics,
Jogging, Cross Country Run, Working
outs using weights/gym equipment, Tai-
Chi etc)
Strand 3:
SEWA
*The circumference measurement of hip and waist of girls must be taken only by lady teachers
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HEALTH AND PHYSICAL EDUCATION 13
HEALTH AND ACTIVITY RECORD
Fitness Test Name What does it Measure Class 9th Class 10th Class 11th Class 12th
Components Fitness Parameters
Health Body BMI Body Mass Index for specific
Components Composition Age and Gender
Muscular Core Partial Curl Abdominal Muscular
Strength up Endurance
Upper Push Up Muscular Endurance
Body
Flexibility Sit and Measures the flexibility of
Reach the lower back and
hamstring muscles
Endurance 600 Meter Run Cardiovascular Fitness/
CardiovascularEndurance
Balance Static Flamingo Ability to balance
Balance Balance Test successfully on a single leg
Skill Agility Shuttle Run Test of speed and agility
Components
Speed Sprint/ Dash Determines acceleration
and Speed
Power Standing Measures the Leg Muscle
Vertical Jump Power
Coordination Plate Tapping Tests speed and
coordination of limb
movement
Alternative Measures hand-eye
Hand Wall coordination
Toss Test
Highlighted tests are mandatory.Details regarding how to conduct tests are available at
https://schoolfitness.kheloindia.gov.in/UploadedFiles/SampleData/AdminManual.pdf
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