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LOCAL HEALTH DEPARTMENT BUDGET <br /> N.C.Department of Environment, <br /> Health,and Natural Resources Revision Number <br /> Division of General Services <br /> SFY Division of Maternal and Child Health <br /> P.O. Number <br /> 5 -1- <br /> Effective Date Termination Date Contract Number <br /> Contractor: f co n 14 np n Activity: Family Planning <br /> Project Director: 712 r); 9 1 L A "t- — Total Budget:$ /Z, 5) 0 <br /> ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br /> E STATE EXPENDITURES: <br /> X Salaries & Fringe Benefits SA/FR 1000 <br /> Operating Expenses OP E)CP 2000 S-) t) <br /> P Purchase of Equipment EQUIP 5000 <br /> E General Contracted or <br /> Purchased Services GENERAL 6100 <br /> N School Health <br /> D Clinician CLN 6863 <br /> Laboratory <br /> T <br /> Pharmacy Services <br /> U Transfer TXIX <br /> R Subtotal State Expend. $ <br /> LOCAL EXPENDITURES: LOCAL EXP 9000 <br /> S TOTAL EXPENDITURES—equal to Total Receipts $ 1�t <br /> LOCAL FUNDS: <br /> R Appropriation APPROP 101 <br /> E T-AIX T)CIX 102 <br /> Other Receipts OTHR REC 103 <br /> Subtotal Local Funds $ <br /> E STATE/FEDERAL/SPECIAL FUNDS: <br /> P <br /> T <br /> Subtotal State/Federal/Special $ <br /> TOTAL RECEIPTS—equal to Total Expenditures $ <br /> Local Authorized Official Signature Date BmrA Had Division/Section Signature Date <br /> wtw <br /> Finance Officer Signature Date Axmuntmt Fiscal Management Signature Date <br /> wtw <br /> DEHNR 2948(Revised 2/93) <br /> General Services Division(Review 2/94) <br />