Download Blood Pressure, Pulse, Weight and Temperature

Blood Pressure, Pulse, Weight
and Temperature Record
Your doctor wants you to take your weight, blood pressure (BP), pulse and
temperature one or more times each day. Take your weight right after using
the bathroom in the morning, using the same scale and same amount of
clothes. Take your temperature, BP and pulse sitting up. Use this monthly
record to keep track.
Sitting/ Resting
Date
Time
BP
Pulse
Weight
Temperature
In pounds
In Fahrenheit
Week 1
More on next page 
Learn more about your health care.
© Copyright June 15, 2012. The Ohio State University
Wexner Medical Center - Upon request all patient
education handouts are available in other formats for
people with special hearing, vision and language needs,
call (614) 293-3191.
Page 2
Sitting/ Resting
Date
Week 2
Week 3
Time
BP
Pulse
Weight
Temperature
In pounds
In Fahrenheit
Page 3
Sitting/ Resting
Date
Week 4
Time
BP
Pulse
Weight
Temperature
In pounds
In Fahrenheit
Page 4
Sitting/ Resting
Date
Time
BP
Pulse
Weight
Temperature
In pounds
In Fahrenheit
Record Keeping
Keep your records and share them with doctors and health care
coordinators so they can monitor your health at each visit.

If you have questions about how to take your blood pressure or pulse,
read the handout, How to Check Your Own Blood Pressure.

Talk to your doctor, nurse or health care team if you have questions or
concerns about what equipment to use or how to take your blood
pressure correctly.

Make copies of this chart or download more copies of this handout for
ongoing tracking of your vital signs.

Talk to your doctor or others on your health care team if you have
any questions. You may request more written information from the
Library for Health Information at (614) 293-3707 or email:
[email protected].