| ee .* eee wa & ee ©, * Ws 4 vy al r , < PSYCH OBSERVATI ON LOG han 4 a REGISTRATION#: ” ae de =) OBSERVATION STARTED: 7 = : s a » “= PLEASE RETURN LOG TO PSYCHOLOGY AFTER vv “THE OBSERVATION HAS ENDED. NP aAT HANK YOU. je mn Ir im * . ay WOE STEMS ALLOWED: ; A SséRRegular Clothes y 2 J ___Safety Toothbrush ( # ~h, Newspaper/Magazine ons Demy, Legal Mail Pi be ws Other Books (softcover only) 4 Safety Pen and Paper Toilet Paper ‘net. oe SW Blanket & SW Mattress must be used even on Psych Observations. wil nothing is checked with a silver marker, only a “8 Suicide Smock and Suicide Blanket are allowed. EFTA00140490

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Name of inmate On Suicide Watch or Psych Obeervaton: BRS EE PHC) Registration #: 3 ~ EATING/SHOWER CHART , A SHOWER __| SHOWER Ag 7 |) F TAY ee ee Wii | | | J Ss es en rT | | | | Jt |. | | -|]| | © | [ fr | | | | | | | | | [| |. [] rT || | | | fo) GS A TS CS a Ss CE rT || | | ES SS I as es es Se ER ec) ECE ES, a Ce EG i ars ee Dz a Cas a Please check the appropriate box if the personon — 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. f Thank you. EFTA00140491

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$:00 Tamate Epstein is Sit tg on +ne bed RM) G5 | Inmate Eyste BiX) |S Pac ng the Tom OS Teak &] Sy ein, ode & Shower ond CE) va Ke will he CEececutire S| Neu sete a cléties —__ > 1g: U5 i lamate iS desti NG dees ded {& of jawy ef Nisit Ca G00 ay nmate Epstein Nas entered G ceguiar WW ING woit- OM) | End o& chit Mbet Mo Dub Cie + 8676 $054 RM EFTA00140502