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Medical Supplies and Expense Schedule 6QO~ 13 Pt,CE 1413 <br />1 2 <br />Total <br />Item Cost <br />N/A <br />Total - Medica Su ies and Ex ense <br />H. Cost of Space - Non-Residential Schedule <br />1 <br />Item <br />2 . <br />Total <br />Cost <br />N/A <br />` <br />I j <br />Total Cost of S ace - Mon-Residential <br />I. Room and Board Costs - Residential Treatment <br />Total i <br />t1 em 2 3 <br />Method of Computation Cost <br />N/A <br />I <br />I <br />i <br />- P-I, dential -reat: <br />V. <br />F:. <br />