Husk at notere alt, hvad du spiser og drikker i løbet af dagen, og noter samtidigt, hvis du oplever symptomer.
Navn: ___________________________________
Cpr.nr.: __________________________________
Dato: ___________________________________
Morgenmad:
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Symptomer:
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Mellemmåltid:
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Symptomer:
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Frokost:
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Symptomer:
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Mellemmåltid:
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Symptomer:
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Aftensmad:
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Symptomer:
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Mellemmåltid:
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Symptomer:
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Drikkevarer:
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Symptomer:
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Motion:
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Symptomer:
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