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<br />,~~~~~, a.~ upc.uea ~~ueuwc <br />(t) <br /> <br />Item (2) <br />Tnt~ <br />Con <br />N/A <br />Toml -Medical Supplies and Expense <br /> <br />H. Cast of Space -Non-Residenral SChedWe <br />P) <br /> <br />Item (z7 <br />Total <br />Cosr <br />N/A <br />ToW Cost of Spae -Non-Residential <br /> <br />1. Room and Board Costs -Residential Treatment <br />C) <br /> <br />Item (z) <br /> <br />Method of Computation (3) <br />Total <br />Cort <br />N/A <br />Tore) Roam and Boats Cans - Residential Treamtevt <br />