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Clinic payment receipt format
A short receipt to give a patient when they pay. It fits on one page and can be saved as a PDF.
Clinic payment receipt format
- Clinic name and address:
- Receipt no.:
- Date:
- Received from:
- Patient ID / phone:
- Against bill no.:
| Description | Amount |
|---|---|
- Total received:
- Payment mode: cash / card / other:
- Reference no., if any:
- Received by (signature):
How to use it
- Issue one receipt for each payment, including part payments.
- Link it to the bill number.
- Write the reference number for card or online payments.
- Keep receipts in number order.
This is a general format. Your accountant can tell you what your receipts must show.
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