🏥 Clinic Details
👤 Client Details
🥗 Nutrition Assessment
✅ Result
👨⚕️ Nutritionist Details
NUTRITION FITNESS
🥗
NUTRI CARE WELLNESS CENTRE
Diet & Nutrition Clinic
12, MG Road, Bangalore - 560001 | Ph: +91 80 4567 8901
Nutrition Fitness Certificate
Cert. No: DN001 | Date: 25 Aug 2026
Client Name
________________
Age / Gender
__ / Male
Height
175 cm
Weight
72 kg
Body Mass Index (BMI)
23.5
Normal Weight
Prescribed Diet Plan
Diet Type
Balanced Diet
Calories
2200 kcal
Protein
120g
Carbs
250g
Remarks: Nutritionally fit, balanced diet recommended
Nutritional Status
NUTRITIONALLY FIT
Valid until: -
Client Signature
NUTRI
FIT ✓
FIT ✓
Dt. Priya Sharma
Dt. Priya Sharma
M.Sc. Food & Nutrition, RD
Reg: RD-12345/2020
M.Sc. Food & Nutrition, RD
Reg: RD-12345/2020