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  • FORMULIR

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    Alan Wijaya
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    16 views1 page

    FORMULIR

    Uploaded by

    Alan Wijaya

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    of 1

    FORMULIR FOOD FREQUENCY

    Nama

    : .

    No. Responden : . Tanggal : .

    Nama Bahan Makanan Makanan Pokok : - Beras - Mie - Roti Lauk Pauk : - Daging Ayam - Daging Sapi - Ikan - Telur - Tempe - Tahu - Ikan Teri Sayuran : - Bayam - Kentang - Buncis - Daun Ubi - Kangkung - Sawi

    Frekuensi Konsumsi
    1 x/hari 2-5 x/minggu 1 x/bulan Tidak Pernah Keterangan

    Buah-buahan : - Nenas - Pepaya - Jambu Biji - Semangka Jenis Jajanan : - Empe-empe - Siomay

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