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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Circular Exhibit 03-03B


JOURNAL VOUCHER FORM

Optional Form (OF) 1017-G (09-79)
Title 7, General Accounting Manual
90107-410
JOURNAL VOUCHER

Journal Voucher No:________________

Date:___________________

REFERENCE EXPLANATION DEBIT CREDIT

Prepared By:___________________________
(Signature)
____________________________________
(Title)
Approved By:___________________________
(Signature)
____________________________________
(Title)


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