2196-7
250
240
230
220
210
200
190
180
170
160
150
140
130
120
110
100
Time
Date
1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031
80
70
60
50
40
90
Notes
Pulse
BLOOD PRESSURE
Name:
Date:
Notes:
BLOOD PRESSURE
RECORD
Example
Systolic
Values
Diastolic
Values
• Make extra copies for future use
Systolic---
Diastolic--- Pulse---
Date---
Time---
Basic Data Setting