EFTA00034435.pdf
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- pdf
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- data-set-8
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Extracted text
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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.
CONFIDENTIAL
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