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  • Brawijaya Women & Children Hospital Menu Order Form

    Încărcat de

    Karuni
    135 vizualizări1 pagină
    This document appears to be a menu ordering form for patients at the Brawijaya Women & Children Hospital in Jakarta, Indonesia. The form includes fields for patient information and diet, and lists breakfast, lunch and dinner menu options separated into categories like drinks, eggs, and other items. Notes indicate that the ordered food will be adjusted according to the patient's diet. The document also lists different colored sheets that correspond to invoice, hospital, and kitchen copies of the form.

    Descriere originală:

    Captain Order

    Titlu original

    Captain Order

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    © © All Rights Reserved

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    This document appears to be a menu ordering form for patients at the Brawijaya Women & Children Hospital in Jakarta, Indonesia. The form includes fields for patient information and diet, and lists breakfast, lunch and dinner menu options separated into categories like drinks, eggs, and other items. Notes indicate that the ordered food will be adjusted according to the patient's diet. The document also lists different colored sheets that correspond to invoice, hospital, and kitchen copies of the form.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca XLS, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    135 vizualizări1 pagină

    Brawijaya Women & Children Hospital Menu Order Form

    Încărcat de

    Karuni
    This document appears to be a menu ordering form for patients at the Brawijaya Women & Children Hospital in Jakarta, Indonesia. The form includes fields for patient information and diet, and lists breakfast, lunch and dinner menu options separated into categories like drinks, eggs, and other items. Notes indicate that the ordered food will be adjusted according to the patient's diet. The document also lists different colored sheets that correspond to invoice, hospital, and kitchen copies of the form.

    Drepturi de autor:

    © All Rights Reserved
    Descărcați ca XLS, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 1

    Brawijaya Women & Children Hospital Brawijaya Women & Children Hospital Brawijaya Women & Children Hospital

    Jl. Taman Brawijaya No. 1, Cipete Utara, Jakarta Selatan 12150 Jl. Taman Brawijaya No. 1, Cipete Utara, Jakarta Selatan 12150 Jl. Taman Brawijaya No. 1, Cipete Utara, Jakarta Selatan 12150

    ORDER MENU PATIENT ORDER MENU PATIENT ORDER MENU PATIENT

    Day/Date/Time : Day/Date/Time : Day/Date/Time :


    Room / Bed : Room / Bed : Room / Bed :
    Name of Patient : Name of Patient : Name of Patient :
    Diet : Diet : Diet :

    BREAKFAST MENU BREAKFAST MENU BREAKFAST MENU


    DRINKS EGG OTHERS DRINKS EGG OTHERS DRINKS EGG OTHERS

    Milo Boil Egg Milo Boil Egg Milo Boil Egg

    Milk or Hot Scramble Milk or Hot Scramble Milk or Hot Scramble

    Chocolate milk Omelete Chocolate milk Omelete Chocolate milk Omelete

    Non Fat Milk Fried Egg Non Fat Milk Fried Egg Non Fat Milk Fried Egg

    Sweettened Tea Sunny Side Up Sweettened Tea Sunny Side Up Sweettened Tea Sunny Side Up

    Tea Tea Tea

    Coffee Coffee Coffee

    BREAKFAST MENU A BREAKFAST MENU B OTHERS BREAKFAST MENU A BREAKFAST MENU B OTHERS BREAKFAST MENU A BREAKFAST MENU B OTHERS

    LUNCH MENU LUNCH MENU LUNCH MENU

    LUNCH MENU A LUNCH MENU B OTHERS LUNCH MENU A LUNCH MENU B OTHERS LUNCH MENU A LUNCH MENU B OTHERS

    DINNER MENU DINNER MENU DINNER MENU

    DINNER MENU A DINNER MENU B OTHERS DINNER MENU A DINNER MENU B OTHERS DINNER MENU A DINNER MENU B OTHERS

    Patient Ahli Gizi Patient Ahli Gizi Patient Ahli Gizi

    ( ) ( ) ( ) ( ) ( ) ( )

    NOTE : NOTE : NOTE :


    The Ordered Food will be adjust to patient's diet The Ordered Food will be adjust to patient's diet The Ordered Food will be adjust to patient's diet

    *Lembar Putih : Invoice *Lembar Merah : PT. SRI *Lembar Hijau : Kitchen *Lembar Biru : Kitchen * Lembar Kuning : Dinner *Lembar Putih : Invoice *Lembar Merah : PT. SRI *Lembar Hijau : Kitchen *Lembar Biru : Kitchen * Lembar Kuning : Dinner *Lembar Putih : Invoice *Lembar Merah : PT. SRI *Lembar Hijau : Kitchen *Lembar Biru : Kitchen * Lembar Kuning : Dinner

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