EFTA00033715

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fitignariON.020, I NAME: PEG STRATIONef: OBSERVATION STARTED:_ 7 -2 qZL rt OBSERVATION ENDED: ____7 PLEASE RETURN LOG TO PSYCHOLOGY AFTER THE OBSERVATION HAS ENDED. ThANK YOU. ITEIVIS ALLOWED: Regular Clothes Safeh.. Toothbrush Newspaper/Magazine Books isoftcover only) Safety Pen and Paper Toile( Paper ; _--_Legal Mail Other SW Blanket & SW Matti ess . Observations. if nothing is checked with silver marker, only a Suicide Smock and Suicide Blanket are allowed. UUNI- lUtIN I IAL SDNY_00009178 EFTA00033715 Name of Inmate On Suicide Watch or Psych Observation: e . 19a--alli - j Registration #: 1-q-6 3., e r EATING/SHOWER CHART DATE BREAKFAST LUNCH DINNER V cV LIQUIDS OFFERED RECEIVED SHOWER SHOWER 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 SDNY_00009179 EFTA00033716 tia_4_"&3 (8 -05(1 7- aq- 20/1 erateis 8_c_fszpil . _17Ae LA— Cap ..-4:;.f2 1-7,„...k v _ v iAte___04e xcielttA.4).. a -17 ttor0 8,00 oiclig En t51:4- 1/4 . 00:Cu trig iberpat74,10;, L PS.y_ch. Ci ft - i n t e rbl) c 3 ri 0.4 67,p44 es4. kz_:1, to U_n_cl- zcgtetne: pgix :rah 1: t7 n(\ 01. 1- cif lee E psk ei Ix 44 (4; 05 n,