-2MEMSLC_Wr

Mir/ 'Ar ^ -2MEMSLC_Wr -Ill Ls- - Mika= C• q air a I I I re , * 'SP rag or • w- a- S PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. THANK vnu. ITEMS ALLOWED: 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. C,UNI- ILMN I IAL SDNY 00009218 EFTA00139303 Name of Inmate On Suicide Watch or Psych Observation: le E irki VI Registration U: 1931 -05-/ EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER LIQUIDS OFFERED SHOWER RECEIVED SHOWER ' 7116119 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. Th