ime N/A Reed: Tirre N/A Rel.: Separation internists:in. N/A ZOS-124LA0 N/A Special Housing Unit Cell Number Inmate Is In' DS: AD Status MedzalDepattment Notaet NIA IsInmateonMedication: N/A Date Shit ,.. s SH Exercise Out of cell time (Total min/hrs) Comments Medical Staff Sign OIC Signature B