| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 2675 | Amgofil 300ug Inj | 1600 | 1 | 1 | 1,600 | ||
| 2728 | Ampho-B 50 mg Inj | 2750 | 1 | 1 | 2,750 | ||
| GRAND TOTAL | 4,350 | ||||||
| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 2675 | Amgofil 300ug Inj | 1600 | 1 | 1 | 1,600 | ||
| 2728 | Ampho-B 50 mg Inj | 2750 | 1 | 1 | 2,750 | ||
| GRAND TOTAL | 4,350 | ||||||