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• LOCAL HEALTH DEPARTMENT ]BUDGET <br />hN-19- Department of Environment, B <br />Health, and Natural Resources <br />Division of General Services Revision Number <br />SFY Division of Adult Health <br />07 / 91 06/ 92 P. O. Number <br />Effective Date Termination Date / 8 2 5 5 0 6 8 <br />Contract Number <br />Contractor: ORAL MINN IFATTV nrPART%n'KTT <br />kcnvity: Adult Health <br />Project Director: Ikaniel B. Reirrnr <br />ITEM DESCRIP" TION <br />TESTATE EXPENDITURES: <br />Salaries & Fringe Benefits es Operating Expens Purchase of Equipment <br />E General Contracted or <br />N Purchased Services <br />School Health <br />D Clinician <br />I <br />T Laboratory <br />Pharmacy Services <br />U Transfer TXIX <br />R Subtotal State E nd. <br />E LOCAL EXPENDITURES: <br />S <br />Total Budget: $ <br />CLASSIFICATION ITEM <br />SA/FR 1000 <br />OP. EXP 2000 <br />GENERAL 6100 <br />CLN 6863 <br />LAB <br />686 <br />RX SERV 6865 <br />LOCAL EXP 9000 <br />TOTAL EXPENDITURES — equal to Total Receipts <br />LOCAL FUNDS: <br />R Appropriation <br />E TXIX /SSBG Fees <br />Other Receipts <br />C <br />E Subtotal Local Funds <br />STATE/FEDERAL /SPECIAL FUNDS: <br />I <br />P <br />T <br />S <br />Subtotal State/FearrauCr.. -. -i <br />AMOUNT <br />$81 46 <br />APPROP 101 75 105 <br />TX1X /SSBG 102 <br />OTHR REC 103 <br />TOTAL RECEIP'T'S — equal to Total Expenditures <br />Official Signature <br />Dat <br />Lf 7 -T <br />Finance Officer Signature Date <br />~DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/93) <br />$ 81 <br />B""u "°d <br />�"' Divn /Section Signature <br />°`� Date <br />� claw <br />", ..a ZFisca?`N` anagementSignarure Date <br />