Dinner [Prompt: eating out, fish, meat, dessert etc.] Please specify restaurant, or where main ingredients were bought, details Details Time Details Time Snacks Detail brand if known [Prompt: biscuits, sweets, chocolate bars, ice creams etc.] 2 DAYS BEFORE ONSET 4 DAYS BEFORE ONSET 3 DAYS BEFORE ONSET Date: ______________ Date: ______________ Date: ______________ Breakfast: If meal was eaten out, details Lunch If meal was out, details:
Dinner [Prompt: eating out, fish, meat, dessert etc.] Please specify restaurant, or where main ingredients were bought, details Snacks Detail brand if known [Prompt: biscuits, sweets, chocolate bars, ice creams etc.] Details Time Details Time 2 DAYS BEFORE ONSET Date: ______________ 3 DAYS BEFORE ONSET Date: ______________ 4 DAYS BEFORE ONSET Date: ______________ Breakfast: If meal was eaten out, details Lunch If meal was out, details:
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