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LOCAL HEALTH DEPARTMEW BUDGET <br />N.C. Department of Environment, <br />Health, and Natural Resources <br />Division of General Services Revision Number <br />SFY Division of Maternal and Child Health <br />02 / 91 06 / 91 P. O. Number <br />Effective Date Termination Date 5 -Q— -6— $ <br />Contract Number <br />Project Director: Total Budget: $ <br />LOCAL FUNDS: <br />R Appropriation <br />E TXDC /SSBG Fees <br />Other Recei is <br />C <br />E Subtotal Local Funds <br />STATE/FEDERAL /SPECIAL FUNDS: <br />r <br />P <br />T, MCC (mt <br />S <br />Subtotal State/Feei rral /C.,.,-:..1 <br />APPROP 101 <br />TXDC /SS$G 102 1380.00 <br />OTI i�t REC 103 <br />TOTAL RECELPT'S — equal to Total Expenditures <br />Authorized <br />Finance Officer Signature <br />DEHNR 2948 (Revised 2/90) <br />General Services Division (Review 2/91) <br />$8,750.00 <br />$ 8,750.00 <br />$ 10,130.00 <br />1117 S1 <br />L z /� <br />Date aftn& hmd Division/Section Signature Date <br />Date w Fiscal Management Signature ace <br />