Prokalite | YEMEK ISI KONTROL FORMU

Örnek Doküman

Otelcilik Hizmetleri - Form

OH.FR.001 - YEMEK ISI KONTROL FORMU

PDF Dokümanı Gör

Paylaş

DİKKAT! Buradaki bilgiler sağlık profesyonelleri için hazırlanmıştır.
Arama motorları vs. ile bu sayfadaki bilgilere ulaştıysanız, sağlık profesyonellerine danışmadan, sadece buradaki bilgiler ile hareket etmeyiniz.

(Logonuz Burada)

Demo Hastanesi (Prokalite.Com) YEMEK ISI KONTROL FORMU

Doküman Kodu: OH.FR.001

Yayın Tarihi: 29.06.2026

Revizyon Tarihi: -

Revizyon No: -

Sayfa: Otomatik

Servis / Klinik: Tarih:…/……/2026
Servis / Klinik: Tarih:…/……/2026
ÖĞLEN				AKŞAM
	YEMEK ADI	MUTFAKTAKİ SICAKLIK	SERVİS ESNASINDAKİ SICAKLIK	YEMEK ADI	MUTFAKTAKİ SICAKLIK	SERVİS ESNASINDAKİ SICAKLIK					AÇIKLAMA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
YEMEK DAĞITAN PERSONEL ADI SOYADI İMZA			DİYETİSYEN ADI SOYADI İMZA		SORUMLU HEMŞİRE ADI SOYADI İMZA
YEMEK DAĞITAN PERSONEL ADI SOYADI İMZA			DİYETİSYEN ADI SOYADI İMZA		SORUMLU HEMŞİRE ADI SOYADI İMZA

<meta charset="utf-8"/>
<table cellspacing="0" style="border-collapse:collapse; width:1292px">
 <tbody>
  <tr>
   <td colspan="12" rowspan="2" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:72px; text-align:left; vertical-align:middle"><strong><span style="color:#000000; font-size:large">Servis / Klinik: Tarih:…/……/2026</span></strong></td>
  </tr>
  <tr>
  </tr>
  <tr>
   <td colspan="4" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:23px; text-align:center; vertical-align:top"><strong><span style="color:#000000; font-size:large">ÖĞLEN </span></strong></td>
   <td colspan="8" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:top"><strong><span style="color:#000000; font-size:large">AKŞAM</span></strong></td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:51px; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>YEMEK ADI</strong></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>MUTFAKTAKİ SICAKLIK</strong></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>SERVİS ESNASINDAKİ SICAKLIK</strong></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>YEMEK ADI</strong></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>MUTFAKTAKİ SICAKLIK</strong></td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong><span style="color:#000000">SERVİS ESNASINDAKİ SICAKLIK</span></strong></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong><span style="color:#000000">AÇIKLAMA</span></strong></td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">1</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">2</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">3</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">4</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">5</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">6</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">7</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">8</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">9</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">10</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">11</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">12</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">13</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">14</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">15</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">16</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">17</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">18</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">19</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:20px; text-align:center; vertical-align:middle"><span style="color:#000000">20</span></td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"> </td>
   <td colspan="5" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:bottom"> </td>
   <td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left; vertical-align:bottom"> </td>
  </tr>
  <tr>
   <td colspan="3" rowspan="2" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; height:40px; text-align:center; vertical-align:middle"><strong><span style="color:#000000">YEMEK DAĞITAN PERSONEL ADI SOYADI İMZA</span></strong></td>
   <td colspan="2" rowspan="2" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong><span style="color:#000000">DİYETİSYEN ADI SOYADI İMZA</span></strong></td>
   <td colspan="7" rowspan="2" style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong><span style="color:#000000">SORUMLU HEMŞİRE ADI SOYADI İMZA</span></strong></td>
  </tr>
  <tr><br type="_moz">
    
  </tr>
 </tbody>
</table>