EFTA00033926

iztiipssuarioN Loo,p? I NAME: S - 6'q REGISMATIONef: 70-b OBSERVATION STARTED:_ —7 —2q ZL rt OBSERVATION ENDED: 7 PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. MANE: YOU. 1TEIVIS ALLOWED: Regular Clothes Safety Toothbrush Newspaper/Magazine _``_Books isoftcover only) Safety Pen and Paper Toiler Paper ; ' Other SW Bianet & SW Mattress Observations. U nothing is checked with a Smock and Suicide Blanket are allowed. silver in:ulcer, only a Suicide UUNI- lUtIN I IAL SDNY_00009648 EFTA00033926 Name of Inmate On Suicide Watch or Psych Observation: e;Paa-ae- Registration #: EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER z /9 8. 31VAI C- LIQUIDS 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 heiust 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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