Cm
Umur : .............................................................. BB : ................ Kg
IMT (Indeks Masa Tubuh) :............................................................
Kebutuhan Gizi Sehari :
Kalori : Kkal Lemak : gram
PEMERINTAH KABUPATEN SERANG
Protein: gram Karbohidrat : gram
DINAS KESEHATAN
UPT PUSKESMAS KEC. KRAMATWATU
PEMBAGIAN MAKANAN SEHARI
Jln Raya Serang – Cilegon Km 8, Kramatwatu -
Serangtelpon (0254) 230585
Pagi Jam 06.00-08.00 E-mail : pkmkramatwatu19@gmail.com
Berat(gr) * URT
Nasi /pengganti : ...................... .......................
Hewani/nabati
Sayuran
Minyak
Gula pasir
:
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:
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Pagi
Contoh Menu Sehari
Siang Malam
DIET
Selingan Jam 10.00 :
................................................................................................................
Nasi Tim
Telur Dadar
Setup Wortel
Nasi Tim
Semur daging
Tim Tahu
Nasi Tim
Ikan panggang
bumbu tomat
LAMBUNG
Teh manis encer Sayur Bening Tumis Tempe
Siang Jam 12.00 – 13.00 : Pepaya Setup Buncis
Nasi /pengganti : ...................... ....................... Pisang
Hewani : ...................... ....................... Selingan Selingan
Nabati : ...................... ....................... Snack Snack Selingan
Sayuran : ...................... ....................... Biskuit Poeding Susu
Buah : ...................... ....................... Susu rendah - Susu
Minyak : ...................... ....................... lemak