| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| ROOM TO READ CAMBODIA | CHC/PPI/C-1050 |
Full Payment | CL/CHC/PPI/21231 | CL/CHC/PPI/21231-01 |
Maternity Benefit | HEAP SREYTOUCH | 400.00 |