โครงการขอรับการสนับสนุนงบประมาณจากกองทุนหลักประกันสุขภาพเทศบาลนครรังสิต



pic กท. ๑
โครงการขอรับการสนับสนุนงบประมาณจากกองทุนหลักประกันสุขภาพเทศบาลนครรังสิต
ประจำปีงบประมาณ พ.ศ.

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ชื่อโครงการ
      

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1. วัตถุประสงค์/ตัวชี้วัด/กลุ่มเป้าหมาย
  1.1 วัตถุประสงค์
  1.2 ตัวชี้วัด
  1.3. กลุ่มเป้าหมาย 

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 คน

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2. วิธีการดำเนินงาน
  2.1 ขั้นเตรียมการ
  2.2 ขั้นดำเนินการ
  2.3 สรุปและรายงานผลการจัดกิจกรรม

3. ระยะเวลาดำเนินการ

4. สถานที่ดำเนินการ

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5. งบประมาณ
     จากงบประมาณกองทุนหลักประกันสุขภาพเทศบาลนครรังสิตจำนวน 0.00 บาท
รายละเอียด ดังนี้

6. ผลที่คาดว่าจะได้รับ

7. สรุปโครงการ
(ผู้เสนอฯ ลงรายละเอียด โดยในแต่ละข้อย่อยให้เลือกเพียง 1 รายการที่เป็นรายการหลักสำหรับใช้ในการจำแนกประเภทเท่านั้น เพื่อให้เจ้าหน้าที่ อปท. บันทึกข้อมูลลงโปรแกรมกองทุนฯ เมื่อได้รับอนุมัติแล้ว)

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  7.1 หน่วยงาน/องค์กร/กลุ่มคน ที่รับผิดชอบโครงการ (ตามประกาศคณะกรรมการหลักประกันฯ พ.ศ. 2557 ข้อ 7)
   ชื่อหน่วยงาน/องค์กร/กลุ่มคน  

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  7.2 ประเภทการสนับสนุน (ตามประกาศคณะกรรมการหลักประกันฯ พ.ศ. 2561 ข้อ 10)
    
  7.3 กลุ่มเป้าหมายหลัก (ตามแนบท้ายประกาศคณะอนุกรรมการส่งเสริมสุขภาพและป้องกันโรคฯ พ.ศ. 2557)
    
  7.4 กิจกรรมหลักตามกลุ่มเป้าหมายหลัก
    

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8.ผู้รับผิดชอบ ( ชื่อกลุ่ม/องค์กร/หน่วยงาน)

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( ผู้เสนอโครงการ )   
ตำแหน่ง 

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