| First appointment | Systolic blood pressure 1st reading |
| Diastolic blood pressure 1st reading | |
| Pulse rate 1st reading | |
| Second appointment | Systolic blood pressure 2nd reading |
| Diastolic blood pressure 2nd reading | |
| Pulse rate 2nd reading | |
| Third appointment | Systolic blood pressure 3rd reading |
| Diastolic blood pressure 3rd reading | |
| Pulse rate 3rd reading |
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