| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 10062 | 2772-2407 | Ayan Aziz | Caricef DS 30ml Syp | 310 | 1 | 1 | 310 |
| 10116 | 2772-2407 | Ayan Aziz | 22G IV Canulla Introcan | 400 | 2 | 1 | 400 |
| 10141 | 2772-2407 | Ayan Aziz | Cyclomide 500mg Inj | 300 | 1 | 1 | 300 |
| 10153 | 2772-2407 | Ayan Aziz | Folinic acid (Leucocin) 50mg Inj | 725 | 2 | 2 | 1,450 |
| GRAND TOTAL | 2,460 | ||||||