PSYCH OBSERVATION LOG Ensthin 163 ae 7 OBSERVATION ENDED: [10/19 / Am >. “i Ve PLEASE RETURN LOG TO PSYCHOLOGY AFTER Ma “THE OBSERVATION HAS ENDED. can, QTHANK YOU. A Cape tyes 00 IN a Si Da Oe. Dems auowen: lA ; fs Regular Clothes ae ale Safety Toothbrush Thee y op 4 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. "7 If nothing is checked with a silver marker, only a “8 Suicide Smock and Suicide Blanket are allowed. SDNY_00009631 EFTA00139379

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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. CONFIDENTIAL SDNY_00009632 EFTA00139380

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vy MW G15 (Es ; > inmate EvsSTeim is Stn , ON Tie Bec V | wn are t VSI Q\ \ ) \c \ i {\O) + Y) eC eer ye A // Lamar& & Se Cin eS LK, va a Shower sind SE) \ ~\\ J ' A> rte Lilt he veces a. S Neu Set ae (cthe. S ~ ay. aA / 4} UY! ( : mo . ——— | L fy SDNY_00009643 EFTA00139391