Checkups and Tests Record

Use this record to write down the date you receive the tests and the results. Try to remember to bring it with you each time you see a doctor.

This record will also help you keep track of when you need your next test or checkup.

Checkup/Test Date/Results
Blood Pressure            
Blood Sugar            
Bone Density            
Cholesterol            
Dental Visits            
Hearing            
Tuberculosis            
Vision            
Weight            


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Pocket Guide to Staying Healthy at 50+