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, LOCAL HEALTH DEPARTMENT BUDGET . <br />1.C. Depa~nen of Environment, ~ 1} <br />Health, and Natural Resources ,,e Revision Number _ _ <br />Division of General Services ~'jj <br />(~ DiviBlon of Maternal and Child Health ~~~~.~ <br />~- P. O. Number <br />Effective Date Termination Date Contract Number <br />:ontractor: nra„gA ~.,. Haat th nQ~t <br />'roject Director: Tlar,i Pt R R ai mr~r <br />ITEM DESCRIPTION <br />E STATE EXPENDITURES: <br />X Salaries & Fringe Benefits <br />Operating Expenses <br />P 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 />jJ Transfer TXIX <br />R Subtotal State Expend. <br />Activity: Family Planning <br />Total Budget: $ s ~ 7 <br />CLASSIFICATION ITEM <br />AMOUNT <br />SA/FR 1000 527 <br />OP EXP 2000 <br />EQUIP 5000 <br />GENERAL 6100 <br />CLN 6863 <br />OCAL EXPENDITURES: LOCAL EXP 9000 <br />S TOTAL EXPENDITURES -equal to Total Rcceipts <br />-6- <br />$ 527 <br /> LOCAL FUNDS: <br />R Appropriation APPROP 101 <br />E - ~~ TXIX 102 <br /> Other Recei is OTHR REC 103 <br />C <br />E Subtotal Local Funds $ {~- <br /> STATE/FEDERAL/SPECIAL FUNDS: <br />I <br />" <br />'~~-A <br />~C~N~ <br />l5 (o0 <br />~S- ~ - l <br />5 51- ~5a"7 <br />kXX~ <br />P <br />T <br /> <br />S <br /> Subtotal State/Federal/S ecial $ $~~] <br /> TOTAL RECEIPTS -equal to Total Expenditures $ 5 2 7 <br />V / <br />~ ~9 ~~., ~~ ~ ~ 5 <br />I Authorized Official Signatur ~ Date a wdt~ Division/Sec ' n Signaru Date <br />w ~ <br />Finance Officer Signarure Date ~~~~ Fiscal Management Si a re Date <br />~EHNR 2948 (Revised 2/93) f ~ RECEIVED ~ <br />~enerai Smites Division (Review 2/94) ~~ G13 J U L 0 6 199~t ~ <br />