EFTA00035074.pdf

OBSERVATION STARTED: PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. 4 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 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. 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