Don't have a way to scan the schematic, but the circuit is simple enough to describe. This is a 10 k input unbalanced to balanced output low-z, usually runs around 20 db gain, and is a pretty flat (frequency response) out to around 15 kc. or so.
Parts list: 10 K-ohm resistors (1/4 watt fine) qty. 8
2/ 100 Ohm resistors; one 15 turn 100k pot.
47 uf electrolytics, (3); two .01 mylar or similar caps for power supply rails by-pass; two 27 pf. ceramic; TLO-72 IC.
The TLO 72 is set up as two separate amplifiers. The first stage is pin 3, non-inverting input (+), pin 2 inverting input(-), and pin 1, output. The second stage, pin 5 non-inverting input, pin 6 inverting input, and pin 7 output. The first stage provides the positive going portion of the balanced output, the second stage is fed from the first into the inverting input and provides the negative goi8ng portion of the balanced output. Gain is set with a feedback resistor on the first stage. The 27PF ceramics provide frequency compensation so the amp is not too broad. Requires a bi-polar power supply, +15 vdc to pin 8, -15 vdc to pin 4, use the two .01 mylar caps to bypass the supply rails to ground.
Circuit: Unbalanced input to pin 3 of the IC through a 10K resistor, 10 k from pin 3 to ground. Pin 2 connected to ground through a 10 k, then 47 uf cap. Pin 2 and Pin 1 connected together through the 100k variable resistor. The 27 pf ceramic parallels the 100 k variable between Pin 1 and pin 2.
The output of the first stage from pin 1 goes through a 100 ohm resistor, then a 47 uf cap. (this could be non-polarized, but polarized seems to work fine). This is the (+) output portion of the balanced out. The output side of the cap is connected to ground through a 10 k resistor.
Another 10 k resistor goes from Pin 1 of the first stage to the inverting input (pin 6) of the second stage. The non-inverting input (pin 5, is grounded through a 10 k resistor. The "feedback loop" on this second stage is a 10 k resistor paralleled with another 27 pf ceramic. The output of this second stage, pin 7, goes through a 100 ohm resistor and another 47 uf cap. The output side of this cap is also coupled to ground through another 10 k resistor. This will be the low (-) side of your balanced output.
I usually build these things on little perf board cards available from Radio Shack, which have traces etched for dual-in-line IC's. Then I mount them in a utility box with RCA phone jacks in, since a typical use is for boosting the output of consumer Cassette or CD players to "line level" to feed a console.
Power supply can be made with 7915/7815 regulators...here's a circuit I found with a quick Google search; you can probably find others that are more legible...
http://www.elecfree.com/circuit/power-supply/power-supply-regulator-15v-15v-1a-by-ic-7815-7915/