Free Form 02AG018E (SUOA-S-34) - Oklahoma


File Size: 154.7 kB
Pages: 1
File Format: PDF
State: Oklahoma
Category: Court Forms - State
Author: Planning Research and Statistics (405) 521-3552
Word Count: 117 Words, 754 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.okdhs.org/NR/rdonlyres/C552B293-6639-408D-8364-5172B66C096F/0/02AG018E.pdf

Download Form 02AG018E (SUOA-S-34) ( 154.7 kB)


Preview Form 02AG018E (SUOA-S-34)
*02AG018E-001*
OKLAHOMA DEPARTMENT OF HUMAN SERVICES

Project Menu Plan - Nutrition Program for the Elderly
Project title Meals Month/day/year Meat or alternate 3 oz. cooked, edible portion Vegetables and fruits 2, ½ cup servings Date Date Project director Date Date Date Date

Bread or alternate 1 serving Butter or fortified margarine - 1 teaspoon Dessert - ½ cup Milk - ½ pint Beverage, optional Prepared by: Dietitian/nutritionist Date Check with Nutrition Program Advisory Council. Menus must be planned for a minimum of six weeks. Forward to OKDHS, Aging Services Division, two weeks prior to use date, by the 15th of January, April, July, and October. Submit with nutrition analysis.

OKDHS issued 1-25-2007

02AG018E (SUOA-S-34)

Page 1 of 1