| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 33480 | 3627-2505 | Gul mawaz | N/S 500ML Inf | 100 | 5 | 3 | 300 |
| 33484 | 3627-2505 | Gul mawaz | 5% dextrose 1/2 saline 500ml Inf | 105 | 1 | 0 | 0 |
| 33489 | 3627-2505 | Gul mawaz | 10cc Syringe Disp | 70 | 13 | 13 | 910 |
| 33490 | 3627-2505 | Gul mawaz | 20cc Syringe Disp | 90 | 3 | 3 | 270 |
| 33491 | 3627-2505 | Gul mawaz | 1cc Syringe Disp | 20 | 2 | 2 | 40 |
| 33494 | 3627-2505 | Gul mawaz | IV Set | 150 | 2 | 2 | 300 |
| GRAND TOTAL | 1,820 | ||||||