| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 39761 | 3281-2502 | M Ishaq | R/L 1000ml Inf | 145 | 2 | 2 | 290 |
| 39762 | 3281-2502 | M Ishaq | 5% dextrose 1/2 saline 500ml Inf | 115 | 2 | 2 | 230 |
| 39763 | 3281-2502 | M Ishaq | 5% dextose 100ml Inf | 85 | 1 | 1 | 85 |
| 39765 | 3281-2502 | M Ishaq | 5% Dextrose 1000ml Inf | 130 | 2 | 2 | 260 |
| 39766 | 3281-2502 | M Ishaq | 10% dextose 1000ml Inf | 145 | 1 | 1 | 145 |
| 39804 | 3281-2502 | M Ishaq | Amkeen 500mg Inj | 400 | 1 | 1 | 400 |
| 39836 | 3281-2502 | M Ishaq | HiCartiff 100mg Inj | 125 | 2 | 2 | 250 |
| 39863 | 3281-2502 | M Ishaq | Folinic acid (Leucocin) 50mg Inj | 750 | 5 | 5 | 3,750 |
| 39864 | 3281-2502 | M Ishaq | Kefcef 1g Inj | 450 | 2 | 2 | 900 |
| GRAND TOTAL | 6,310 | ||||||