Cetin,

This is cool, does the FLOOR(CAST()) take it down to just numeric representation of the date?

SELECT  t1.*
FROM    dbo.co_Pat_HeightWeightHistory t1
        INNER JOIN ( SELECT FLOOR(CAST(TransactionDT AS float)) AS dGroup,
                            MAX(TransactionDT) AS TransactionDT
                     FROM   dbo.co_Pat_HeightWeightHistory
                     WHERE  patientID = @PatientID
                     GROUP BY FLOOR(CAST(TransactionDT AS float))
                   ) t2 ON t1.TransactionDT = t2.TransactionDT
WHERE   patientID = @PatientID
order by pathwid Desc