PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. HANK YOU. 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. A lf nothing is checked with a silver marker, only a Suicide Smock and Suicide Blanket are allowed. EFTA00120121

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Name of Inmate On Suicide Watch or Psych Observation:AESErk Registration #1: 1631S — 65 1 4 EATING/SHOWER CHART DATE BREAKFAST -7-91 7/i4 LUNCH DINNER LIQU 7 OFFERED SHOWER RECEIVED SHOWER 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. Thank you. EFTA00120133