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DEPARTMENT OF HEALTH and SOCIAL SERVICES I
PATIENTS PERSONAL EFFECTS RECEIPT
Facility: Da{e:
Name ................_....... ........__ , . , .,,,, Activity:
Sent or Left
Rdaticnship ·
Address
Received
Item / sz
Quan. DESCRIPTION I
Received and Recorded at CENTRAL CLOTHING SUPPLY V
By Date ____.....________,.__ V
Received a¢...........___._Blda· ¤r Ward
Datc,.,____________,__._
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Case 1:08-cv-00173-JJF
Document 9
Filed 04/09/2008
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Document 9
Filed 04/09/2008
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Case 1:08-cv-00173-JJF
Document 9
Filed 04/09/2008
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Case 1:08-cv-00173-JJF
Document 9
Filed 04/09/2008
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