OBSERVATION STARTED:

OBSERVATION STARTED: PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. a THANK YOU. ITEMS ALLOWED: Regular Clothes Safety Toothbrush Newspaper/Magazine Books (softcover only) Safety Pen and Paper Toilet Paper Legal Mail Other SW Blanket & SW Mattress must be used even on Psych Observations. A If nothing is checked with a silver marker, only a Suicide Smock and Suicide Blanket are allowed. EFTA00110466 Name of Inmate On Suicide Watch or Psych Observation: Registration #: -)3q-O51-i EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER LIQUIDS 774 at' 17 OFFERED SHOWER RECEIVED SHOWER 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. EFTA00110467 •Z/,t(ltetY alvi OP}) t A j r , ( , e q 1 1 ) _ s c i g i e _ a A v i _kat_