Don’t want the hassle of designing a hospital receipt from scratch?
Grab our free hospital receipt template in your preferred format, including Google Sheets, Word, Excel, Google Docs, and PDF. It’s simple to personalize and ideal for transparent, accurate medical billing.
You can also browse our full selection of free receipt templates for additional healthcare-friendly layouts.
What Is a Hospital Receipt Template?
A hospital receipt template is a pre-formatted document that healthcare facilities use to provide patients with an itemized record of medical services rendered and payments received.
This standardized template ensures consistent documentation, simplifies billing processes, and provides patients with clear proof of payment for insurance claims or personal records.
Download Spreadsheet Daddy’s Free Hospital Receipt Template
Our Hospital Receipt Template provides a professional format for documenting patient payments and medical services rendered.
You can customize it by adding or removing columns to suit your specific healthcare facility’s requirements.
Grab your free blank hospital receipt template by choosing the format you need from the links below:
What’s included
- Multi-row itemization table: A table with four structured columns (Description, Quantity, Unit Cost, Amount) enables you to list medical services, procedures, medications, treatments, lab tests, or additional healthcare charges with a precise pricing breakdown for transparency and clarity.
- Customizable hospital branding section: The header area includes editable fields for your hospital name, complete address, email, and phone number, allowing you to personalize the receipt with your facility’s official contact information and maintain professional branding consistency.
- Comprehensive patient billing details: A dedicated “Bill To” section captures essential patient information, including full name, email address, physical address, and phone number, ensuring complete records for billing purposes, insurance claims, and patient communication.
- Automated financial calculation fields: Built-in calculation areas include subtotal, adjustable tax rate percentage, tax amount, and total amount due, providing clear financial summaries and ensuring accurate billing totals without manual computation errors.
- Professional documentation features: The template includes fields for payment date, receipt number, payment method selection, a notes section for additional terms or instructions, and a courteous closing message, creating a complete and professional medical billing document suitable for official hospital records.
How to Use Our Hospital Receipt Template
1. Access this hospital receipt template as an Excel, Word, or PDF file, or open it in Google Sheets or Google Docs for easy editing.
2. Enter your hospital’s details at the top of the receipt, including the facility name, email, address, phone number, and logo.
3. Provide the patient’s billing information, along with the payment date, receipt number, and the method of payment used.
4. List all services or medical supplies provided. Add the quantity and price for each item, and the template will automatically calculate the totals.
5. Include any applicable tax rate. The template will generate the subtotal, tax amount, and final balance due for you.
6. Use the Notes section to highlight important information such as follow-up instructions, special billing remarks, or additional details.
