EFTA00059564

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S cn -46311-O5M 6 'als'N 3 i k n Ste v% •S‘ ezi:WIS 7-•-4-- --k,: 5: Gm MrneA Il' h I 'Wt. ---,:: 5 A)-- ,, • ::;•,' 34 .vnynch\e_ics)5 \-evv) 1b 5 y-)8 • - -1-.. . ?en __4_, cm , . -Qpskc\Y\ -4e-P n A. 1 t vnynke- NE) t,i 6,. 4 o_ps\reAr., t5 .5\ge -Sct ‘nyra t 9w\s ...- -4 -4 5 ,4 s ICI • Co9n) PA ‘_evn ik- '3Col itrnare CitOOk 4 ",. r f\-QAY vs 4a\kg\n't N° ck ea' ____ Yot‘N \\ke 7:gr.; tc4eyn As. - c. tn.c/nok.ie. co;ZyrsvoiectMcLA. -,• "7— '. 00 ttAr2 4 -4 Oc 4a \c\ - lit ::1-1---n ro sfoti nexA) cetie- tacf42reigas4}Nez. 2.---t 7fiosc) - Ai fpskm - Jo 4la crave- -aitexii .7. / 1:2,11:W Lit( f r /..2-a_. ALA Ca" • Ili #4 .1 - ani. EFTA00059588 Name of Inmate On Suicide Watch or Psych Observation: Registration It: 1743/ff —or-ie EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER LIQUIDS OFFERED SHOWER RECEIVED SHOWER #16 (/ / // V L irt ri.vhq i/ 7/a V) i/. 71 t/i t/ V 1./ il Please check the appropriate box if the person on Suicide Watch/Psych Observation actually eats his meal. Do not check the box if he just received it, but did not eat it. Place a check in the "Liquids" box each time the person drinks. Thank you. EFTA00059589