=============================================== Receipts for Month of ............ ----+---------------------------------+----+--- ....|Bal. on hand from previous month |....|... ....|From In-Patients |....|... ....| ” Out-Patients |....|... ....| ” Private Nursing |....|... ....| ” Special Nursing |....|... ....| ” Sale of Medicine & Supplies |....|... ....| ” Entertainments |....|... ....| ” Interest on Invested Funds |....|... ....| ” Annual Contributions |....|... ....| ” Other Sources |....|... | Total $..........|....|... | Balance ..........|....|... ----+---------------------------------+----+--- =============================================== Disbursements for Mo. of ........ 19... ----+---------------------------------+----+--- ....|Balance for previous month |....|... ....|For Meat |....|... ....| ” Fish |....|... ....| ” Butter |....|... ....| ” Flour, Bread and Meal |....|... ....| ” Milk |....|... ....| ” Water |....|... ....| ” Ice |....|... ....| ” Potatoes and Vegetables |....|... ....| ” Groceries and Provisions not | | | above enumerated |....|... ....| ” Soap and Cleaning Appliances |....|... ....| ” Fuel |....|... ....| ” Gas, Oil and Light |....|... ....| ” Bedding and Gen. House Fur. |....|... ....| ” Nurses’ Uniforms |....|... ....| ” Other Training School Ex. |....|... ....| ” Wines and Spirits |....|... ....| ” Drugs and Surgical Appliances|....|... ....| ” Surgical Dressings |....|... ....| ” Advertising, Print. & Postage|....|... ....| ” Repairs |....|... ....| ” Taxes and Insurance |....|... ....| ” Contingencies |....|... | Total $..........|....|... | Balance ..........|....|... ----+---------------------------------+----+---