| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 8900 | 2808-2409 | Fatima Tabassum | Sandimmun 50/5ml Inj | 700 | 9 | 1 | 700 |
| 8905 | 2808-2409 | Fatima Tabassum | Suprimun 500mg tab | 110 | 7 | 7 | 770 |
| 8907 | 2808-2409 | Fatima Tabassum | Acylex (Hypovir) 60ml Syp | 220 | 1 | 1 | 220 |
| 8909 | 2808-2409 | Fatima Tabassum | Motilium 120ml Syp | 150 | 1 | 1 | 150 |
| 8911 | 2808-2409 | Fatima Tabassum | Ulsanic 120ml Syp | 400 | 1 | 1 | 400 |
| 8966 | 2808-2409 | Fatima Tabassum | Avil 25mg/ml Inj | 11 | 1 | 1 | 11 |
| 8969 | 2808-2409 | Fatima Tabassum | MGSO4 (Epsium ) 10ML Inj | 30 | 1 | 1 | 30 |
| 8972 | 2808-2409 | Fatima Tabassum | Dexamedron 4mg Inj | 12 | 3 | 3 | 36 |
| 8978 | 2808-2409 | Fatima Tabassum | Solomed 125mg Inj | 250 | 1 | 1 | 250 |
| 8990 | 2808-2409 | Fatima Tabassum | Provas (Fevagesic) 1g inj | 150 | 2 | 2 | 300 |
| 8997 | 2808-2409 | Fatima Tabassum | Ticoplan 400mg Inj | 1900 | 1 | 1 | 1,900 |
| 9001 | 2808-2409 | Fatima Tabassum | Onset 8 mg INJ | 170 | 8 | 8 | 1,360 |
| GRAND TOTAL | 6,127 | ||||||