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Name: _____________________________________________

First day

Weight
pounds

Water
ounces

Last day

Week: ______________________

Sugar Level
fasting

Measures
Breast
Waist
Hips

First day

First day

Last day

Last day

Breakfast:
_____________________________________________________________________________________
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Lunch:
_____________________________________________________________________________________
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_____________________________________________________________________________________
First day
Last day
First day
Last day
Sugar level
Sugar level
Before meal
2 hrs. after meal
Dinner:
_____________________________________________________________________________________
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Exercise:
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