Suicide Watch

Suicide Watch Chronological Log Inmate Companions Log Name of inmate on watch: Lp 5 -c Register #: li4 9°Ol l- G54 Institution: Date Watch Began / Ended ONLY ITEMS ALLOWED: E 2 9-) CU "O as :O eri V) V) V) To be completed by Chief Psychologist at conclusion of watch: Booklet of Suicide Mattress SWCL - INMATE EFTA00110502 STAPLE LOCAL PROCEDURES HERE Check one of the following: 0 This is the initial log book for this suicide watch. Enter date and time watch began: 0 This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. EFTA00110503 Suicide Watch Observation Log Name of inmate - 1 „ „._ on watch: 4JY -it i ( 1 Reg Si: 143 10• .5q Date: -1 23e Time Observations: Briefly note your observations. Initial all entries. Initials j:Lj0 M &"4 5k+ ,,,,,..„ 40 sin it i (