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Anyone help with a WW diet record sheet

My Dad has just phoned me to say he forgot to get a sheet to record his daily food consumption and points on this week and he won't see the WW leader again for two weeks as he has a hospital appointment next week.

Can anyone on WW please scan a blank one and post on here so I can see exactly what it looks like? I will then be able produce a replica (ish) in excel. I've put something together but my Dad is a pensioner and insists it has to be exactly like the one he usually has. :D
He wants it asap and it's too far for me to go and see him and then com back and type it up and then go back over to his.

Can anyone please help me out with this?
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Queen of the Damned
If you PM me your email address, I can send you one :)