Blood Pressure Log

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Nima Goharkhay, MD, PhD, FACOG
Board Certified
Maternal Fetal Medicine
BLOOD PRESSURE LOG
Name
____________________________________ DOB____________________________
Phone Nr.
Date
Time
Systolic
Diastolic
1h after
Date
Time
Systolic
Diastolic
(High Number)
(Low Number)
Breakfast
(High Number)
(Low Number)
Fax: (281) 605-6800
Email:

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