EFTA00034435

oviggratkoN.400,/ I NAME: PECTSMATIONef: 703 t 0 sq OBSERVATION STAP.TED:_ 7 — ZL Ict OBSERVATION ENDED: 7 PLEASE RETURN i.OO TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. THANK YOU. 1TEIVIS ALLOWED: "" Regular Clothes Safety Toothbrush Newspaperfivlapazine \r__Books isoftcover only) Pen and Paper __Toile( Paper ; _____Legal Mail ' Other SW Blanket & SW Mattress must he used even on Psych . Observations. If nothing is checked with a silver marker, only a Suicide Smock and Suicide Blanket Are allowed. UUNI- IULN I I/AL SDNY_00010977 EFTA00034435 Name of Inmate On Suicide Watch or Psych Observation: e .19a--alli -j Registration #: EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER /9 8. 31VAI V LIQUIDS OFFERED SHOWER RECEIVED SHOWER C - 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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