Child Weekly Diet Routine
Child's name:
Parent's name:
Mother's Status:
Address:
Telephone number:
Email:
Is your child in Kidzee:
Child's Age: Yrs.
Child's Gender:
Child's Statistics: Height    
  Weight    Kg
Eating Habits:
Food Choices:
  1) Roti/Chapati/Puri/Paratha: Yes No
  2) Rice: Yes No
  3) Milk: Yes No
  Milk If Yes: Plain Milk With Nutritional Supplements
  4) Vegetables: Yes No
List of Vegetables taken in meals during a week:
List of Leafy Vegetables taken in meals during a week:
List of fruits taken in meals during a week:
Junk Food: Yes No
Please specify how often the child consumes junk food and the list of the food items:
Food allergies (Please Specify):
Child's pediatricians: Name         
City            
Location   
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