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BLOOD PRESSURE HOME MONITORING RECORDName:______________________________________ Date of birth:______________________________________ Emis:______________________________________ (completed by staff on receipt) Tips! Record your blood pressure twice in the morning and twice in the eveningSit quietly for 5 minutes before each pair of readingsLeave at least one minute between each measurement. Write both results in the boxes.Systolic (syst) is the higher number – Diastolic (diastol) is the lower of the twoWhenever possible, return the completed form to the Practice a week prior to your appointmentIf you haven’t got time, bring it along to the appointment.Morning ReadingsEvening ReadingsDayDateReading Onesyst diastolReading Twosyst diastolDayDateReading Onesyst diastolReading Twosyst diastol110211312413514615716817918On completion return to: Surgery Reception – scan to VC for processing ................
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