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LOCAL HEALTH DEPARTMENT BUDGET <br />N.C. Department of Environment, <br />Health, and Natural Resources �n1 Revision Number --Q J — f <br />Division of General Services <br />SFY Division of Maternal and Chad Health <br />P. O. Number <br />m/ 40 06/91 _ 9 1 5 4 3 0 0 6 8 <br />Effective Date Terminanon Date Contract Number <br />Contractor: <br />Project Director: DMJA]. S_ Rpimar _ <br />Activity: Family Planning <br />Total Budget: $ 3,416.99 <br />LOCAL FUNDS: <br />R Appropriation <br />E TX1X /SSBG Fees <br />C Other Recei is <br />Subtotal Local Funds <br />E-- <br />STATE/FEDERAL/SPECIAL FUNDS: <br />I - <br />P <br />T <br />S <br />Subtotal <br />TOTAL <br />, Y <br />Finance Officer Signature <br />DEHNR 2448 (RcvL;ed 2 /9o) <br />General Services Division (Review 2/91) <br />APPROP 101 <br />TXIX /SSBG 102 <br />OTHR REC 103 <br />— equal to Total Expenditures <br />3,416.00 m <br />3,416.00 m <br />Date - br�h Hca .- :.Division /Section Signature - . Date <br />Dare Fiscal Management Signature Date <br />