462 



INFLUENCE OF FOOD PEE8ERVATIVES ON HEALTH. 



SAMPLES OF RECORD AND CALCULATION FORMS. 



DAILY CHART. 

 [To be filled out by each member of the Hygienic Table.] 



Name and number: F. C. W., No. 2. 

 Date: April 25, 1903. 



<i Firm, soft, very soft, semiliquid. 



1903. 



66 grams. 



MEAL REPORT, HYGIENIC TABLE. 



DINNER MENU. 



SUNDAY, April 26, 



Name and number of member, F. C. W., No. 2. 

 Roast chicken) 

 Roast turkey / " 



Creamed potatoes 100 grams. 



Fresh peas 75 grams. 



Cranberries grams. 



Fresh strawberries 100 grams. 



Bread 75 grains. 



Butter 13. 5 grams. 



Sugar 30 grams. 



Coffee cc. 



Cocoa cc. 



Tea cc. 



Milk 400 cc. 



Water cc. 



N. B. Each space must be filled out either with a figure or a dash. 



