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Kadar Denyutan Nadi / Ulangan / cm Naik Turun Bangku (Kadar Denyutan Nadi ) Tekan Tubi ( Ulangan ) Ringkuk Tubi Separa ( Ulangan ) Jangkauan Melunjur ( cm ) Jumlah Skor Keseluruhan Gred ( A / B / C / D / E ) Indeks Jisim Badan Nama Penguji Tandatangan Penguji