KOMANDO RESORT MILITER 152/BABULLAH TENSI

JASMANI MILITER

BLANGKO LAPANGAN TES KESAMAPTAAN JASMANI

I. DATA DIRI.
1. Nama : .............................................................................
2. Pangkat/Corp/NRP : .............................................................................
3. Tempat & Tanggal La hir : .............................................................................
4. Jabatan : .............................................................................
5. Kesatuan : .............................................................................
II. PELAKSANAAN.
1. Hari/Tanggal : .............................................................................
2. Pukul : .............................................................................
3. Tempat
a. Rik/Uji Postur : ..................................................................
b. Tes Kesegaran Jasmani : ..................................................................
c. Tes Ketangkasan : ..................................................................

III. KESAMAPTAAN JASMANI.

1. Perbandingan TB/BB
a. Tinggi Badan : .............................................................................
b. Berat Badan : .............................................................................
c. Klasifikasi : .............................................................................

2. Kesegaran Jasmani
a. Kesegaran Jasmani “A”
KELILING (P. LINTASAN .........METER TTD TTD
JARAK
1 2 3 4 5 6 7 8 9 10 SISA JARAK TESTEE TESTOR

b. Kesegaran Jasmani “B”

TANDA TANGAN TANDA TANGAN
MATERI KUANTITAS (KALI)
TESTEE TESTOR
PULL UPS 1. 1.
SIT UPS 2. 2.
PUSH UPS 3. 3.
LUNGES 4 4.
5 5
SHUTTLE RUN
3. Ketangkasan Jasmani.
MATERI WAKTU TEMPUH TTD TESTEE TTD TESTOR
Renang Dasar Jarak 50 Meter
Gaya Dada
KOMANDO DAERAH MILITER XVI/PATTIMURA TENSI
JASMANI MILITER

BLANGKO LAPANGAN TES KESAMAPTAAN JASMANI

LAT RAIDER YONIF RK 732/BANAU TA. 2019
I. DATA DIRI.
1. Nama : .............................................................................
2. Pangkat/Corp/NRP : .............................................................................
3. Tempat & Tanggal Lahir : .............................................................................
4. Jabatan : .............................................................................
5. Kesatuan : .............................................................................
II. PELAKSANAAN.
1. Hari/Tanggal : .............................................................................
2. Pukul : .............................................................................
3. Tempat
a. Rik/Uji Postur : ..................................................................
b. Tes Kesegaran Jasmani : ..................................................................
c. Tes Ketangkasan : ..................................................................

III. KESAMAPTAAN JASMANI.

1. Perbandingan TB/BB
a. Tinggi Badan : .............................................................................
b. Berat Badan : .............................................................................
c. Klasifikasi : .............................................................................

2. Kesegaran Jasmani
a. Kesegaran Jasmani “A”

KELILING (P. LINTASAN .........METER TTD TTD

JARAK
1 2 3 4 5 6 7 8 9 10 SISA JARAK TESTEE TESTOR

b. Kesegaran Jasmani “B”

TANDA TANGAN TANDA TANGAN
MATERI KUANTITAS (KALI)
TESTEE TESTOR
PULL UPS 1 1
SIT UPS 2 2
PUSH UPS 3
3 4
LUNGES 4
5
SHUTTLE RUN 5
3. Ketangkasan Jasmani.
MATERI WAKTU TEMPUH TTD TESTEE TTD TESTOR
Renang Militer Dasar Jarak 50 M
Gaya Dada
Jailolo, Maret 2019
Pjs. Kepala Jasmani Militer 152/Bbl

Heru Darujito
Kapten Inf NRP 21960016511276