Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Course Syllabus
Course Title:
Physical Assessment /Practice
Course code: 911218
Course prerequisite(s) and/or co requisite(s):
Anatomy and Physiology in Human
Fundamentals of Nursing
Adult Nursing Theory and Practice
Course Level: 2nd year
Lecture Time: Sunday and Tuesday
(8-12 12 MD)
Credit hours: 3 Credit hours
Academic Staff Specifics
Name
Rank
Office No &
Location
E-mail Address
Mrs. TAGREED
MARJI, SN. MSN
Course
coordinator 403/ ext.2196
Lecturer
Mr. AWAD
KHAWALDEH
tmarji@philadelphia.edu.jo
15521, fifth floor
Course Tutor
faculty of nursing awad.khawaldeh@yahoo.com
assistants
Tel. ext: 2189
Course Description
This course is designed for nursing students who are learning to interview patients, to
examine them and to understand and assess their health problems. This course provides the
skill foundation for health assessment, physical examination and clinical experience for
implementing knowledge into practice setting. This course is also designed for mastering the
different techniques of physical examination; identify abnormalities with special emphasis to
the common and or important problems.
Page 1 of 29
Course Objectives:
 Initiate the interview with the patient. Prepare equipments & supplies necessary for
physical exam.
 Provide patient's privacy during the examination.
 Connect data about the patient health history accurately.
 Assess the patient's different body systems.
 Demonstrate head to toe assessment.
 Practice physical examination in different positions.
 Recognize the different health problems facing patients.
 Provide patient psychological support.
 Formulate nursing diagnosis for each problem according to physical examination
ndings.
Module Outline and Course Academic Calendar
Week
Date
(1)
(2)
7-9/10/2012
14-16/10/2012
(3)
21-25/10/2012
(4)
(4)
28/10/2012
30/10/2012
(5)
4-6/11/2012
(6)
11--13/11/2012
(7)
18--20/11/2012
(8)
(9)
25--27/11/2012
2--4/12/2012
(10)
9—11/12/2012
(11)
16--18/12/2012
(12)
23/12/2012
(12)
(13)
25/12/2012
30/12/2012
(13)
(14)
1/1/2013
13-15/2013
Page 2 of 29
Subject
Introduction
Patient interview "collecting of subjective and objective data
and Techniques of physical exam
Assessment of Skin. Hair .and Nail
Demonstration in Hospital
Holyday eid al-adha
Physical assessment of head and neck.
Demonstration in Hospital
Assessment of Eye and Ear.
Demonstration in Hospital
Assessment of the mouth, throat and nose.
Demonstration in Hospital
Assessment of the thorax anterior and posterior.
Demonstration in Hospital
Mid-term Exam
Assessment of the heart.
Demonstration in Hospital
Assessment of the peripheral vascular system.
Demonstration in Hospital
Physical assessment of the abdomen.
Demonstration in Hospital
Assessment of muscle & skeletal systems.
Christmas holyday
Assessment of the nervous systems and mental health.
Demonstration in Hospital
New year holyday
Final exam
Course Evaluation
Modes of Assessment:
Mid term exam
Professionalism
Hospital assignments & quizzes
Score
30
10
20
Final Exam (Comprehensive )
written
verbal, demonstration)
TOTAL
40
10
30
100
Date
25--27/11/2012
Appendix
1,2,3,4,5,6,7,8
13/1/2013
15/1/2013
Make-up exams will be offered for valid reasons only with consent of the Dean. Make-up
exams may be different from regular exams in content and format.
Textbook:
Title: Title: Health assessment in nursing./2007
Author(s)/Editor(s): JANET WEBAR AND JANE KELLY
Publisher: Lippincott Williams
ISBN:
In addition to the above, the students will be provided with handouts by the lecturer.
Module References
Students will be expected to give the same attention to these references as given to the Module
textbook(s)
1. Physical examination and health assessment 2004/ Caroline Jarvis.
2. www.philadelphia.edu.jo/nursing/resource.
Teaching Methods:
1.Lab sessions,
2.Discussion,
3.Demonstration,
4.Role play.
5.Modules and audio visual aid
Attendance Policy:
Policy Guide:









Each student should arrive on time for each clinical day.
Students should be at the hospital in full uniform ready for work
at the latest. Two lates are considered one absence.
Students are only allowed two clinical day absences with acceptable excuses.
Any student who exceeds his/her absences limit will be suspended from the
clinical course and given a grade of 35%.
Jewelry should be kept to a minimum
Make-up for female student should be avoided as possible (to the
Minimum)
Long hair should always be tied up.
Uniforms should always be clean and tidy. Name tags are essential.
Male students with beards should keep them clean and trimmed
Page 3 of 29








Female students should wear white or brown stockings and white shoes with
their white uniforms.
Male students should wear black shoes and navy blue pants only. Navy blue tie
are required for the uniform. Uniform jackets should be short not long as lab
coats.
Each student is required to have the following supplies on each clinical day:
1-a blue pen
2-a red pen
3- a measurement meter
4- Adequate paper for writing
Students should always be on their best behavior.
Students should always respect their clinical instructors.
Students should always demonstrate professional behavior when dealing with their
clients, their peers, and other health care Professionals and instructors.
Students should communicate effectively with health team members, peers and
instructors
All major procedures should be done under the supervision of a clinical
instructor.
Students who lack experience and skill in performing procedures should review
them in the nursing lab until they become safe and efficient.
Attendance Policy:
Absence from lectures and/or tutorials shall not exceed 15%. Students who exceed the 15%
limit without a medical or emergency excuse acceptable to and approved by the Dean of the
relevant college/faculty shall not be allowed to take the final examination and shall receive a
mark of zero for the course. If the excuse is approved by the Dean, the student shall be
considered to have withdrawn from the course.
On average you should expect to spend at least (8) hours per week on this module.
Page 4 of 29
Appendix two
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Skin hair and nails
Student Name:……………………………………………..
Student number:…………………………………………..
Date of Interview:…………………………………………
1.
Biographical/Demographic Data:
Client Initials:
Room/Bed:
Age:
Floor:
Sex:
Marital Status:
Religion:
Educational:
Occupation:
Medical diagnosis:
Surgical Operation:
Date of surgery:
Diet:
Activity limitation:
Date of Admission:
2. Subjective data : (1 mark)
Any current problems or changes of skin:
Hx of Skin Disease:
Nails:
3. Objective data:
A.
Skin (1 mark)
Color and pigmentation:
Temperature:
Turgor:
Moisture:
Page 5 of 29
Lesions:
Rashes:
B.
Nails (1 mark)
Shape & configuration:
Color:
Capillary refill:
Any abnormalities:
C. Any unusual observation with: (1 mark)
Scalp:
Page 6 of 29
Hair:
Appendix three
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Head and neck
Student Name:……………………………………………..
Student number:…………………………………………..
Date of Interview:…………………………………………
1. SUBJECTIVE DATA : (1 mark)
A. Headache :
B. Injuries \ infections:
C. Dizziness \ vertigo :
D. Neck pain
2. OBJECTIVE DATA:
A.
Face (1 mark)
Folds:
Expression:
Temporal pulse:
B.
Skull, Scalp and Head (1 mark)
Size:
Symmetry
Scalp findings:
E.
Neck (1 mark)
Centralization:
Masses/Edema:
Page 7 of 29
Carotid Artery:
F.
Lymph Nodes (1 mark)
Size:
Shape:
Tenderness:
Mobility:
G.
Thyroid Gland(1 mark)
Bulging: Size:
Shape:
Tenderness:
Nodules:
Page 8 of 29
Appendix four
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Mouth,throat.nose and sinuses
Student Name:……………………………………………..
Student number:…………………………………………..
Date of Interview:…………………………………………
1.
Biographical/Demographic Data:
Client Initials:
Room/Location:
Sex:
Marital Status:
Educational:
Occupation:
Medical diagnosis:
Surgical Operation:
Diet:
Activity limitation:
2. Subjective data : (1 mark)
Any current problems or changes:
Problems (mouth and throat)
Problems (Nose):
Sense of Smell and Taste Altered:
Difficulty in Swallowing:
Hoarseness
3. Objective data:
A. Nose:
Page 9 of 29
Age:
Date of surgery:
Date of Admission:
External nose:
Patency of nostrils:
B. Mouth and throat
Lips:
Gums:
Buccal mucosa:
Tongue:
Tonsils:
Uvula:
Teeth:
Sinuses:
Frontal sinus:
Maxillary sinus:
Page 10 of 29
Appendix five
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Cardiovascular
Date of Interview:
Student name:
Student NO:
__________________________________________________________
1. Biographical/Demographic Data:
Client initial:
admission date:
Age:
Sex:
Education:
Marital Status:
occupation:
Medical diagnosis:
surgery:
bed/room
Surgical Operation:
diet:
activity limitation:
2- Subjective data:
Chest pain: ……………………………………..
Palpitations:……………………………………………………
Hx Murmur:…………………………………………………….
Hypertension: ………………………………………………….
Bleeding and Bruising:………………………………………..
Anemia:……………………………………………………….
Blood Transfusions:…………………………………………...
3- Current Health Status
Reason for Visit: ………………………………………….
Page 11 of 29
Date of
…………………………………………………………….
Hx of Present Illness:……………………………………..
……………………………………………………………
Symptom:…………………………………………………
Objectives data:
B/P – Lying:…………………………………………………………
Standing:…………………………………………………………….
Sitting:……………………………………………………………….
Heart rate: …………………………… rhythm:……………………..
Capillary refill:………………………………………………………..
Edema: ……………………….. location: amount (+1 - + 4):…………
Quality (pitting, non-pitting):…………………………………………….
Heart and Neck Blood Vessels:
Carotid :
Apical Pulse:
rate:
Rhythm:
strength
Pulse Deficit:
Auscultation:
Abnormal finding sound:
Jugular vein:
Present (degree of bed elevated):
Estimated jugular venous pressure (CVP):
Page 12 of 29
Heart sound:
S1 (location & causes):…………………………………………………..
……………………………………………………………………………
S2 (location & causes):…………………………………………………...
……………………………………………………………………………
Murmur present:…………………………………………………………
……………………
Page 13 of 29
Appendix six
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Abdomen
Student Name:…………………………………….
Student Number:………………………………….
Date of Interview:…………………………………
1. Biographical/Demographic Data: (1 mark)
Client Initials:……………….Ward/ Room:………………….
Age: ………………………Birthplace: ………………………Sex:………………
Marital Status:…………… Religion:…………………………Occupation:…………..
Medical diagnosis: ……………………date of admission:………………………
Surgical procedure:…………………
date of surgery:…………………………
Diet: …………………….. Activity limitation:…………………. Allergy:…………..
Transportation to Hospital (if applicable):
………………………………………………………………………………………..
2. Current Health Status(subjective data): (1 marks)
Any Problems: (Nausea, Vomitting, Indigestion, Infection:………………………...
…………………………………………………………………………………………..
…………………………………………………………………………………………..
Pain (COLDSPA):………………………………………………………………………
………………………………………………………………………………………….
Appetite Change: ……………………………………………………………………….
…………………………………………………………………………………………..
Bowel Habits and Consistency:………………………………………………………..
…………………………………………………………………………………………..
Rectal Pain, Hemorrhoids, Rectal Bleeding:……………………………………………
…………………………………………………………………………………………..
…………………………………………………………………………………………..
Food sensitivity & tolerance: …………………………………………………………..
………………………………………………………………………………………….
Page 14 of 29
Medication (past& current):…………………………………………………………….
………………………………………………………………………………………….
3. objective data: (8 marks)
Abdomen
 Inspection:
Skin condition:………………………………………………………………………….
………………………………………………………………………………………….
Shape:…………………………………………………………………………………...
Symmetry: ……………………………………………………………………………..
Scars: …………………………………………………………………………………..
………………………………………………………………………………………….
…………………………………………………………………………………………
………………………………………………………………………………………....
Hernia: …………………………………………………………………………………
………………………………………………………………………………………….
Stria:………………………………………………………………………………….
…………………………………………………………………………………………
Umbilicus:……………………………………………………………………………..
…………………………………………………………………………………………

Auscultation:
Bowel Sounds: URQ: …………………………….. ULQ: ……………………………
LRQ: ……………………………...LLQ:…………………………….

Percussion:
Over all abdomen:………………………………………………………………………
Liver edge & liver span:…………………………………………………………..........
…………………………………………………………………………………………..
…………………………………………………………………………………………..
Spleen size: ……………………………………………………………………………
………………………………………………………………………………………….
Blunt palpation:…………………………………………………………………………
………………………………………………………………………………………….
Page 15 of 29

Palpation:
Hocks sign:……………………………………………………………………………...
………………………………………………………………………………………….
Mourphy sign:…………………………………………………………………………..
………………………………………………………………………………………….
Rebound Tenderness:…………………………………………………………………...
………………………………………………………………………………………..…
Iliopsoas sign:…………………………………………………………………………..
………………………………………………………………………………………….
Obturator sign:…………………………………………………………………………
…………………………………………………………………………………………
Aortic palpation:………………………………………………………………………
………………………………………………………………………………………...
Page 16 of 29
Appendix seven
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Musculoskeletal
Student Name:…………………………………….
Student Number:………………………………….
Date of Interview:…………………………………
1. Biographical/Demographic Data:
Client Initials:
Age:
Sex:
Occupation:
Medical diagnosis:
Room:
Birth place:
Marital Status:
date of admission:
2. Current Health Status
Reason for Visit:
Hx of Present Illness:
Symptom Analysis:
Other Known Health Problems:
3. General Health State
Weight:
Height:
Fatigue/weakness:
Ability to Carry Out ADL:
4. Musculoskeletal:
Any Problems with Muscles:
Any Problems with Bones:
Any Problems with Joints:
Hx of Arthritis, Gout, etc:
Page 17 of 29
Any Change:
Any Problems with Walking:
Back Problems:
(Hx of Trauma):
A- Temporomandibular Joint
Snapping/clicking:
Pain, crepitus:
Locking:
ROM: 1-----------------------------------------2-----------------------------------3------------------------------------------------------------------------------------Strength of muscle:………………………………………………………
…………………………………………………………………………..
B-Neck AND spinal:
Crepitation:
Spinal Curvature:
Posture:
ROM:
1234567Muscle Strength (general) 0-5:
Deformities:
Ambulatory Aids:
C-shoulder
ROM
1------------------------------2-------------------------------3--------------------------------4----------------------------------5--------------------------------6----------------------------------Muscle Strength (general) 0-5:
Page 18 of 29
D- Elbow
ROM 1------------------------------------2---------------------------------------3-------------------------------------------4---------------------------------------Muscle Strength (general) 0-5:
E-wrist
(ROM):
Muscle Strength (general) 0-5:
F- Hand
ROM
1-----------------------------------------2-------------------------------------------3-----------------------------------------4-------------------------------------------5------------------------------------------Muscle Strength (general) 0-5:
Phalen test:
Tinel test:
G- Lower limp
-Hip (ROM):
Muscle Strength (general) 0-5:
-Knee (ROM):
Muscle Strength (general) 0-5:
-Ankle and feet (ROM):
Muscle Strength (general) 0-5:
Page 19 of 29
Appendix eight
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
Neurologic system physical examination
Student Name:…………………………………….
Student Number:………………………………….
Date of Interview:…………………………………
 Subjective data:
1. Biographical/Demographic Data: (1 mark)
1. Biographical/Demographic Data:
Client Initials: ………………….
Age:…………………………….
Marital Status:………………….
Education level:…………………
Medical diagnosis:…………………
Weight (wt.):……………………...
Room/Location:……………………
Gender:…………………………
Religion:………………………..
Occupation:…………………….
Diet:……………………………
Height (Ht):………………………..
2. chief complain (Reason for visit):
……………………………………………………………………………………………………………
………………………………………….…………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
………………………………
3. present history illness:
………………………………………………………………………………...……………………………
……………………………...………………………………………………………………………………
……………………………………………………………………………………………...………………
……………………………………………………………………………………………………………
……………………
4. Past health history:
……………………………….……………………………………………………….....…………………
…………………………………………………………………………...…………………………………
…………………………………………………………………………………...…………………………
Page 20 of 29
……………………………………………………………………………………………………………
…………….………
5. Family health history:
………………………………………………………………….…………………………………………
………..……………………………………………………………………………………………………
………...……………...……………………………………………………………………………………
…………………..………………...………………………………………………………………………
……………………………..…………………..…………………………………………………………
……………………………………...………………………………………………………………………
…………………………………………..
 Objectives Data:

Mental status & level of consciousness:
Glasgow coma scale
(GCS):…………………………………………………………………………………
…………………………………………………………………………………………………………
…….
…………………………………………………………………………………………………………
……..
Posture & body
movements:…………………………………………………………………………………
Dress, grooming, &
hygiene:………………………………………………………………………………..
…………………………………………………………………………………………………………
……
Facial
expression:……………………………………………………………………………………………
Speech:………………………………………………………………………………………………
………
Mood, feeling, &
expression:………………………………………………………………………………..
…………………………………………………………………………………………………………
…….
Thought processes &
perceptions:…………………………………………………………………………...
…………………………………………………………………………………………………………
……..
 Cognitive abilities:
Orientation:……………………………………………………………………………………………
…….
Concentration:…………………………………………………………………………………………
…….
Memory (recent &
remote):…………………………………………………………………………………
Using memory in learning new
information:……………………………………………………………….
Page 21 of 29
Abstract
reasoning:………………………………………………………………………………………….
Judgment:……………………………………………………………………………………………
………
Perception (visual, auditory &
tactile):………………………………………………………………………
…………………………………………………………………………………………………………
…….
 Cranial nerves:
CN
I:………………………………………………………………………………………………………
…
…............................................................................................................................................................
.........
CN
II:………………………………………………………………………………………………………
…………………………………………………………………………………………………………
……
CN
III:……………………………………………………………………………………………………
….
…………………………………………………………………………………………………………
…….
CN IV &
VI:…………………………………………………………………………………………………
…………………………………………………………………………………………………………
…….
CN
V:………………………………………………………………………………………………………
...
…………………………………………………………………………………………………………
……..
CN
VII:……………………………………………………………………………………………………
…
…………………………………………………………………………………………………………
…….
CN
VIII:……………………………………………………………………………………………………
...
…………………………………………………………………………………………………………
……..
CN IX &
X:…………………………………………………………………………………………………
…………………………………………………………………………………………………………
……
CN
XI:……………………………………………………………………………………………………
….
…………………………………………………………………………………………………………
…….
Page 22 of 29
CN
XII:……………………………………………………………………………………………………
…
…………………………………………………………………………………………………………
Motor & cerebellar systems:
Motor Functions: muscle strength & ROM
Inspection, Palpation & Range of motion (ROM):
Temporomadibular joint
(TMJ)……………………………………………………………………………
…………………………………………………………………………………………………………
…...
Sternoclavicular
joint:……………………………………………………………………………………….
…………………………………………………………………………………………………………
…….
Cervical, thoracic & lumber
spine:…………………………………………………….…………………...
…………………………………………………………………………………………………………
……
…………………………………………………………………………………………………………
…….
…………………………………………………………………………………………………………
……..
Shoulders, arms, &
elbows:…………………………………………………………………………………
…………………………………………………………………………………………………………
…….
…………………………………………………………………………………………………………
…….
…………………………………………………………………………………………………………
…….
Wrist:…………………………………………………………………………………………………
………
…………………………………………………………………………………………………………
……..
Hands &
fingers:……………………………………………………………………………………………..
…………………………………………………………………………………………………………
……..
Hips:…………………………………………………………………………………………………
…….....
…………………………………………………………………………………………………………
……..
Knee:…………………………………………………………………………………………………
………
…………………………………………………………………………………………………………
…….
Ankles &
feet:………………………………………………………………………………………………
Page 23 of 29
…………………………………………………………………………………………………………
……
 Balance test:
Gait, posture, freedom of movement, symmetry, rhythm &
balance:……………………………………….
…………………………………………………………………………………………………………
…….
Romberg
test:………………………………………………………………………………………………..
Tandem
walk:………………………………………………………………………………………………..
 Coordination:
Finger to
nose:……………………………………………………………………………………………….
Rapid alternative
movement:………………………………………………………………………………...
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………
 Deep Tendon Reflexes:
Biceps:…………………………………………………………………………………………………
…...
Brachioradialis:………………………………………………………………………………………
…….
Triceps:………………………………………………………………………………………………
……..
Patellar:………………………………………………………………………………………………
……..
Achilles:………………………………………………………………………………………………
……..
Ankle:…………………………………………………………………………………………………
…….
 Superficial reflexes:
Plantar
(Babinski):…………………………………………………………………………………………
Abdominal:…………………………………………………………..………………………………
…….
 Sensory Function:
Light touch, pain &
temperature:……………………………………………………………………………
…………………………………………………………………………………………………………
……
Vibration:………………………………………………………………………………………..……
……
Position:………………………………………………………………………………………………
……...
 Tactile Discrimination:
Page 24 of 29
Stereognosis:…………………………………………………………………………………………
………
Graphesthesia:…………………………………………………………………………………………
…….
Two point
discrimination:……………………………………………………………………………………
 Test for meningeal inflammation:
Brzezinski's
sign:…………………………………………………………………………………………….
…………………………………………………………………………………………………………
……..
Kerning
sign:…………………………………………………………………………………………………
…………………………………………………………………………………………………………
……..
Page 25 of 29
Appendix one
Philadelphia University
Faculty of Nursing
First Semester 2012/2013
Clinical Physical Examination
health assessment sheet
(patient interview)
Student Name:……………………………………………..
Student number:…………………………………………..
Date of Interview:…………………………………………
1.
Biographical/Demographic Data: (2 grades)
Client Initials:
Room/Location:
Age:
Birthplace:
Sex:
Marital Status:
Religion:
Educational:
Allergies:
Transportation to Hospital (if applicable):
2.
Current Health Status:( 2 grades)
Chief complain:
Hx of Present Illness:
Health Behaviors: (2 grades)
Page 26 of 29
Occupation:
Screen test:
Relaxation/Stress/Reduction/Exercise:
Nutrition (diet, likes/dislikes/intolerances):
Activity/Exercise:
Sleep/Rest Patterns:
Medications (Prescription; OTC):
Tobacco:
Alcohol:
Seat Belt Use:
Self Esteem / Self Concept:
Coping and Stress Management:
3.
Past Health: (2 grades)
Obstetric Hx:
Childhood Illnesses:
Immunizations (Current):
Hospitalizations/Operations:
Serious or Chronic Illnesses:
Accidents and Injuries:
3. Family History: (2 grades)
4. Major Disorders (cancer, diabetes, hypertension, etc): Health Information about Family
Members:
Genogram (Who lives in home):
Page 27 of 29
Criteria for Evaluation
of Professional Behavior in clinical settings
Criteria of Evaluation
● Attendance (3 Grades)
- Attend all days
- Absent one day without excuse
- Absent two days without excuse
- Absent three days without excuse
3
1.5
1
To be de-registered from the module
(35%)
N.B:- for each one day absence with excuse subtract 0.25 grade from the attendance
Usually
Sometimes
Rarely
● Punctuality (2 Grades)
0.5
0.25
0
- Attend on expected time
- Submit all clinical documents on time
- Submit & present self learning activities
( seminar & patient case study) on time
- Perform all scheduled nursing assessment ,
monitoring and intervention on time
● Uniform (2 Grades)
- Follow the prescribed uniform
- Has clean tidy & complete uniform
(pencil, notes ,file, clinical document…)
- Has Neat appearance (Hair, fingernail,
makeup jewelry,)
- Hung ID university & name badge.
● Relationship\ Communication(1.5 Grades)
- Use verbal and nonverbal communication
skills effectively with:
- Patient and family
- Hospital staff
- Other students(peers)
- Faculty staff
● Leadership abilities (1.5 Grades)
- Be self motivated & self directed
Page 28 of 29
- Evaluate self and peers objectively
- Lead the group effectively
- Follow faculty and hospital policies
TOTAL
10 MARKS
Critical Care Nursing (Clinical)
Daily Evaluation for Lab Sessions
Group: - ………..
Student' name
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Page 29 of 29
Date: - …\ …\ ……….
Attendance
&
Punctuality
Lab coat
&
Badge
Behavior
&
Attitude
(1)
(1)
(1)
Relation
Participation
&
&
Cooperation Demonstration
(1)
(1)
Total
5
MARKS