Unit Cell Numbcr; _ z_o_4-_2_0_6_LA _ D ______ lnmale Is ln: _ _ _ __ NJ_A ____ OS: _ _ _ _ _ N_IA _____ .AD status Is Inmate on Medication- N/A Medical Department Notifled· NIA ··- -- ·--·· ··- ---· - - - ··-- ··· Meals Out of cell time ·-·1 Medicar Date Shirt SH Exercise Staff Sfgn OIC Signature ·s o · s