.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. EFTA00110438 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. EFTA00110439 7.2.q-aolq tge4W4 rpc..4-4PI .et -co, ...) ‘4fra._Cti 8cis-isf 1-744 24- Crik, et_ jp-o-tleta)'oPpA etr14/ Accoma •pxerperAxfubly_scw psych 4 • ..7Cp..664 :-(5 4. is uni i..2„ G- eo. tint); _ogle-- Y:45:pp 721,1CP4cal j CL .5_(C•• cts rks_ _Ecaji 1Xe -room "Tin n el ja:kth_ s ca, 0O1:Sid p n TJM eiz i „i >< ove tjart e c t,34 -oirit-latim -c-p4,:r. A.. cis._ SerecbcoA 1, kR n h,e. lksZe 3741c, :4"114____R nesic;‘, i sTha-yirks e__cca-t_On 101036 -r-Eds_Easj2,apecit.c ./ -.Vct Skcc4eti%_.: io:dok I 1 1/4 G12 5-1-6 n olopears e _sSieWlila i1512PaaTM -E- -31-0M._04ppermiS e cckeep;i1 o; cicAtM14 E-psk LS Awoke aysLitt14/.411.4v, 6.4 LUoopiaE-lo-ti,ei)-- ba - it liet a EFTA00110440 DO Wit O.\ 5 .5 I g-ezii Se_:STEc SS V EIDS-TP1 ;5 SL I a AM. 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