You are on page 1of 2

HEALTHY CHECK RESULT HEALTHY CHECK RESULT

Name : Name :
Age : Age :
Check Date : Check Date :

METHOD NAME UNIT RESULT STANDARD METHOD NAME UNIT RESULT STANDARD

WEIGHT KG - WEIGHT KG -
BLOOD PRESSURE mmHg 120/80 BLOOD PRESSURE mmHg 120/80
SATURATION % 95-99 SATURATION % 95-99
GLUCOSE Mg/dl 70-125 GLUCOSE Mg/dl 70-125
URIC ACID Mg/dl 3,4-7 URIC ACID Mg/dl 3,4-7
CHOLESTEROL Mg/dl 0-200 CHOLESTEROL Mg/dl 0-200

HEALTHY CHECK RESULT HEALTHY CHECK RESULT


Name : Name :
Age : Age :
Check Date : Check Date :

METHOD NAME UNIT RESULT STANDARD METHOD NAME UNIT RESULT STANDARD

WEIGHT KG - WEIGHT KG -
BLOOD PRESSURE mmHg 120/80 BLOOD PRESSURE mmHg 120/80
SATURATION % 95-99 SATURATION % 95-99
GLUCOSE Mg/dl 70-125 GLUCOSE Mg/dl 70-125
URIC ACID Mg/dl 3,4-7 URIC ACID Mg/dl 3,4-7
CHOLESTEROL Mg/dl 0-200 CHOLESTEROL Mg/dl 0-200
Name
Age
:
:
HEALTHY CHECK HISTORY
DATE
METHOD
UNIT STANDARD
NAME

WEIGHT KG -
BLOOD
PRESSURE mmHg 120/80

SATURATION % 95-99
GLUCOSE Mg/dl 70-125
URIC ACID Mg/dl 3,4-7
CHOLESTEROL Mg/dl 0-200

Name :
Age : HEALTHY CHECK HISTORY
DATE
METHOD UNIT STANDARD
NAME

WEIGHT KG -
BLOOD
PRESSURE mmHg 120/80

SATURATION % 95-99
GLUCOSE Mg/dl 70-125
URIC ACID Mg/dl 3,4-7
CHOLESTEROL Mg/dl 0-200

You might also like