| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 32782 | 2576-2309 | Ammara Sadiqui | Pivacian 5mg/ml Inj | 28 | 1 | 1 | 28 |
| 32804 | 2576-2309 | Ammara Sadiqui | Iso flurane sol 100 ml | 3550 | 1 | 1 | 3,550 |
| 32830 | 2576-2309 | Ammara Sadiqui | ETT Tube Rinforce No 4.5 | 1270 | 1 | 1 | 1,270 |
| GRAND TOTAL | 4,848 | ||||||