NUTRITIONAL Services
Sample Menus: Breakfast Lunch Dinner
dINNER
Please Circle All items Desired.
Portion Size S M L
Cottage Entree
Broiled Swordfish
Other Options
Salisbury Steak*
Soup and Sandwich
Tuna, or Chicken Salad Plate
| Potatoes and Vegetables |
| Mashed Potato |
Mixed Vegetable |
| White Rice |
Stewed tomatoes |
| Fruits and Desserts |
Sugar Free |
| Homemade Cookies* |
Fruit Cocktail |
Sorbet |
| Fig Newtons |
Sliced Peaches |
Ice Cream |
| Ice Cream* |
Applesauce |
Vanilla Pudding |
| Vanilla Pudding |
Fresh Fruit |
Chocolate Pudding |
| Chocolate Pudding |
Jello |
Jello |
| Beverages |
| Hot: |
Cold: |
| Coffee |
Skim Milk |
Carnberry Juice |
| Tea |
Whole Milk* |
Prune Juice |
| Decaf Coffee |
2% Milk |
Apple Juice |
| Decaf Tea |
Iced Tea |
Gingerale |
| Hot Chocolate |
Orange Juice |
Diet Gingerale |
| Sugar Free Hot Choc. |
| Supplement:______________________ |
Name:___________________________ |
Rm :___________ |
| Diet: House WK 1 D1 |
Date:___________ |
| *LIMIT TO REDUCE SODIUM AND/OR SATURATED
FAT INTAKE |
|
