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EFTA00054963_sub_001 - EFTA00054963_100
N/A N/A Authorized: Rel.: Pertinentlnfonnadon: N, Separation Information: N/A Speaal Housing Unit Cee Number. Z04-2061.A0 Inmate Is In; Is Inmateor Medics/Jon: N/A MedicalDePadmentNotilled: Date TSIiit Meals SH Exercise Out of cell time min/hrs) Medical Comments Staff Sign GIC Signature _
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