| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 57705 | 4968-2509 | Umar Abdullah | Xylocaine Gel 2% (xylex) | 120 | 1 | 1 | 120 |
| 57725 | 4968-2509 | Umar Abdullah | 16G LP Needle | 380 | 15 | 10 | 3,800 |
| 57726 | 4968-2509 | Umar Abdullah | Pivacian 5mg/ml Inj | 29 | 1 | 1 | 29 |
| 57788 | 4968-2509 | Umar Abdullah | Acuron (Relocurium) 5ml Inj | 220 | 3 | 3 | 660 |
| 57793 | 4968-2509 | Umar Abdullah | Toradol (Tekac) 30 mg/ml Inj | 120 | 1 | 1 | 120 |
| 57795 | 4968-2509 | Umar Abdullah | Propofal 1% Inj | 550 | 1 | 1 | 550 |
| GRAND TOTAL | 5,279 | ||||||