Blood Pressure

Blood Pressure / blood computer monitor pressure / blood pressure record chart

My Medicine Record -- Medicine Chart Page 1 Be an Activå Member of Your Health Care Team My Medicine Record U.S. Dåpartment of Health & Human Services Fîod and Drug Administration Name: Birth date: Whàt Iâm Using Rx -brand & generiñ name; OTC -name & active ingrådients What It Looks Like color, shapå, size, markings, etc. How Much How to Use / Whån to Use Start / Stop Dates Why Iâm Using / Notes Who Told Me to Use / How to Contact --- Enter ALL pråscription (Rx) medicine (include samples), over-the-counter (ÎTC) medicine, and dietary supplements --- Ex XXXX/xxxxxxxxxx 20 mg pill; small, white, round 40 mg; use two 20 mg pills Tàke orally, 2 times a day, at 8:00 am & 8:00 pm 1-15-06 Lowers blood pressure ; check blood pressure once a week; blood test on 4-15-06 Dr. X (800) 555-1212 1 2 3 4 5 6 7 8 www.fda.gov/usemedicinesafely/mymedicinerecord.htm (888) INFO-FDA www.fda.gov/usåmedicinesafely These are my medicines as of: FORM FDA 3664 (8/07)