| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 36732 | 3577-2504 | Fazal rabi | Nocid 20mg tab | 15 | 10 | 10 | 150 |
| 36734 | 3577-2504 | Fazal rabi | Suprimun 500mg tab | 125 | 9 | 0 | 0 |
| 36851 | 3577-2504 | Fazal rabi | Urso 500mg Cap | 118 | 15 | 15 | 1,770 |
| GRAND TOTAL | 1,920 | ||||||