| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 47458 | 4142-2507 | Ibad Shah | 5% dextrose 1/2 saline 500ml Inf | 120 | 4 | 4 | 480 |
| 47460 | 4142-2507 | Ibad Shah | 5% Dextrose 500ml Inf | 110 | 2 | 2 | 220 |
| 47565 | 4142-2507 | Ibad Shah | Omotil 0.25mg/5ml Inj | 500 | 1 | 1 | 500 |
| 47582 | 4142-2507 | Ibad Shah | Lasix (Frusemide) 20mg Inj | 10 | 9 | 9 | 90 |
| GRAND TOTAL | 1,290 | ||||||