| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 11200 | 2772-2407 | Ayan Aziz | 18G IV Canulla Vasofix | 180 | 4 | 4 | 720 |
| 11261 | 2772-2407 | Ayan Aziz | Merem 1g Inj | 1600 | 1 | 1 | 1,600 |
| 11274 | 2772-2407 | Ayan Aziz | Erthropoietin (MacEpo) 10000iu Inj | 2500 | 1 | 1 | 2,500 |
| 11284 | 2772-2407 | Ayan Aziz | Colistim 1MIU Inj | 900 | 1 | 1 | 900 |
| 11297 | 2772-2407 | Ayan Aziz | Transamine (Brino) 250mg Inj | 60 | 4 | 4 | 240 |
| GRAND TOTAL | 5,960 | ||||||