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Knowledge is the best medicine

Medication Record

To order your medication record, please call 1-800-363-0203 or e-mail knowledge@canadapharma.org .

*List all* prescription and non-prescription medicine.**
DATE	NAME, DOSE & DIRECTIONS	REASON













Cross out each medication when finished.

Record your blood pressure and glucose levels.
DATE	BLOOD PRESSURE	GLUCOSE LEVEL 1	2	4	4

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