OBSERVATION STARTED:
PLEASE RETURN LOG TO PSYCHOLOGY AFTER
4THE OBSERVATION HAS ENDED.
THANK YOU.
ITEMS ALI.OWED:
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.
#d If nothing is checked with a silver marker, only a
Suicide Smock and Suicide Blanket are allowed.
EFTA00035074
Name of Inmate On Suicide Watch or Psych Observation:
Registration #: -)3q-O51-i
EATING/SHOWER CHART
DATE BREAKFAST LUNCH DINNER LIQUIDS OFFERED RECEIVED
SHOWER SHOWER
at' 17
774
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.
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