Blood Pressure Readings form First name(s) Surname Your date of birth What is the 1st line of your address? NHS No. An NHS number is a 10-digit number, like 485 777 3456. If known, please enter your NHS number in the field below. You can find more information on the NHS website Day 1 AM Day 1 PM Day 2 AM Day 2 PM Day 3 AM Day 3 PM Day 4 AM Day 4 PM Day 5 AM Day 5 PM Day 6 AM Day 6 PM Day 7 AM Day 7 PM Are you a smoker? No Yes What is your weekly alcohol intake? What is your weight? What is your height?