Blood Glucose Log Template

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Complete Blood Glucose Log Template with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

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Nima Goharkhay, MD, PhD, FACOG
Board Certified
Maternal Fetal Medicine
BLOOD GLUCOSE LOG
Name
____________________________________ DOB____________________________
Phone Nr.
Date
Time
Fasting
Time
1h after
Time
1h after
Time
1h after
3AM – ONLY
Breakfast
Lunch
Dinner
if requested
Fax: (281) 605-6800
Email:

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