Three Day Food And Fluid Chart - Nhs Lothian Page 2
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Please complete this three day food and fluid intake chart
and record everything that you eat and drink.
Time of drink 8.30am – Breakfast
Record how much your mug or cup holds in mls or fluid ozs
meal/snack: Medium white toast,1 slice, butter and jam
Tea and milk – 250mls
and also the time of meals and snacks.
Date:
Date:
Day 1
Day 2
Time of drink
Time of drink
meal/snack:
meal/snack:
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