| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| YEANTHAN THORMACHEATGAS | CHC/PPI/CR1-1073 |
Full Payment | CL/CHC/PPI/20601 | CL/CHC/PPI/20601-03 |
IN-PATIENT | Chea Chansokhany | 127.53 |