| ID | MR# | PATIENT NAME | MEDICINE | RATE | REFUND REQUEST | REFUNDED QTY | TOTAL |
|---|---|---|---|---|---|---|---|
| 62047 | 7036-2604 | Adan Fatima ( Donor of Niaz Ahmed) | Calamox 625mg Tab | 35 | 8 | 8 | 280 |
| 62051 | 7036-2604 | Adan Fatima ( Donor of Niaz Ahmed) | 5% dextrose 1/2 saline 500ml Inf | 120 | 1 | 0 | 0 |
| 62054 | 7036-2604 | Adan Fatima ( Donor of Niaz Ahmed) | IV Set | 200 | 1 | 1 | 200 |
| GRAND TOTAL | 480 | ||||||