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Name Ideal peak flow number: Date Medication Usage Time AM PM AM PM AM PM AM PM AM PM AM PM AM PM AM PM AM PM AM PM AM PM AM PM 700 600 500 400 300 200 100 Know the early warning signs of a sudden asthma attack: • • • • • • Shortness of breath Tightness in your chest Difficulty breathing Wheezing Coughing Drop in peak flow number Special Instructions Use this space to write down any special information or instructions you receive from your doctor..