Name: _____________________________________________________
My Target Blood Pressure is: ___________________________________
I am to call my healthcare practitioner:
if my blood pressure goes above ________ or falls below ________.
if I have the following symptoms: ____________________________
_______ ______
D
T
ATE
IME
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B
P
LOOD
RESSURE
____________ ____________________________
B
P
LOOD
RESSURE
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L
OG
C
OMMENTS