| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 52099 | 6457-2602 | Abu Zar Rana | N/S 500ML Inf | 110 | 1 | 1 | 110 |
| 52100 | 6457-2602 | Abu Zar Rana | 5% dextrose 1/2 saline 500ml Inf | 120 | 1 | 1 | 120 |
| 52103 | 6457-2602 | Abu Zar Rana | 10cc Syringe Disp | 70 | 7 | 8 | 560 |
| 52104 | 6457-2602 | Abu Zar Rana | 20cc Syringe Disp | 90 | 5 | 5 | 450 |
| 52112 | 6457-2602 | Abu Zar Rana | Avil 25mg/ml Inj | 20 | 2 | 1 | 20 |
| 52123 | 6457-2602 | Abu Zar Rana | Lasix (Frusemide) 20mg Inj | 10 | 2 | 3 | 30 |
| GRAND TOTAL | 1,290 | ||||||