EFTA00035087

.RVATION LOG _Y I NAME: C .ES±e REGiSTRATIONtf: 7(.2-6 I & 0 sel OBSERVATION STARTED:_ 7 - 2‘1 — 20. Ict PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. THANK YOU. crguis ALLOWED: • fr\s I' Regular Clothes • 71 -Safety Toothbrush .. i r Newspaperfivlagazine O00kS (softcover only), ) v Safety Pen and Paper Toilet Paper Mail Other SW Blanket & SW Mattress must he used even on Psych . Observations. If nothing is checked with a silver marker, only a Suicide Smock and Suicide Blanket.: re allowed. EFTA00035087 Name of Inmate On Suicide Watch or Psych Observation: e;adf if Registration It: 9 -6 pjr EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER LIQUIDS OFFERED SHOWER RECEIVED SHOWER / 7 t V — IV" - "..-->"----- e.--- t./ 19 j,,,,er• - WM ‘.e2. '• (/ / li • , _._ .,___.:„..• • ___L-: .: ::., — _ Please check the appropriate box if the person on 'Suicide Watch/Psych Observation actually eats his meal. Do not check the box if helust received it, but did not eat it. Place a check in the "Liquids" box each time the person drinks. Thank you. EFTA00035088 EiaALLS*:&31taact_ t_Sak a t a c49,0-2."_ 1:7 -7 - aq-zolef 'rite p 7150114, 5C1,74.- rce -Or0 ,-)e, c51(24pLaticr_c-2151:4-1/4 Asa; meg iberpottn,,bly -7-t2t2tbs-t r psifa;r1 743:17V --6 ',Sep vi lb/ 4.54 - it is ics..N-:75. t (..2812__ Z. CStAtr:G -‘ -ti ii : /41—E F IC-Jer;rt Pi% . icidei EpAci s 4.S k.' n3 n., ecbra q-itcf,iftzfier-Fo:ei rx, d ,_5 VT afr.-- rte. 9 ,1. -c-; e jAic-TIALcaTe:rt ct -&-e--cci)00-1 I 1 ---L Y," (7, 3±_€C p64_11-7/11 Eps ; s ta.7CrIc5_ 9._uce_cke_oniaL,sufn •-•7- legc°94_.th_E4:1412 42.pevcs._AiLiStAiewitAc (et. 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