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Name of Inmate On Suicide Watch or Psych Observation: ERE PSHein Registration #: ~ DATE BREAKFAST | LUNCH EATING/SHOWER CHART OFFERED RECEIVED SHOWER SHOWER Please check the appropriate box if the person on Suicide Watch/Psych Observation actually éats 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. CO N F | DE NTIAL SDNY_00009219 EFTA00139304

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