Excellent | # of meals per day |4-5 | Prepared by | mother | Eats alone or with others |mother | |Food likes / dislikes |Food Allergies | NKA | Reaction | n/a | Religious Requirements | none | Recent Weight Gain / Loss | none | Dysphagia | N | |Bowel Habits (frequency, consistency of stool, use of laxatives) |Urinary Elimination (frequency, dysuria, complaints) | 4-5 times a day; no complaints…
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