Kingsway Medical Practice NHS GP Surgery in Manchester

Blood pressure readings (1 day)

Blood Pressure Review (1 day)

Section

Smoking status

Smoker

Never smoked

Ex-smoker

How many per day do you smoke?

When did you give up smoking?

Your Blood Pressure

Date:

Please use this date format: DD/MM/YYYY.

Morning Measurement

Systolic “Higher”

/

Diastolic “Lower”

Heart Rate

Evening Measurement

Systolic “Higher”

/

Diastolic “Lower”

Heart Rate

I confirm that the information provided is accurate to the best of my knowledge

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