[Hospital Name] [HospitalAddress]
RECEIPT VOUCHER

Receipt No	[rcno]	By Cash/CHQ/DD/Card/Bank	[Type]
Receipt Date	[rcdate]	[Date]	[TDATE]
[depbank lbl]	[depbank]	[No]	[TypeNo]
[Banklbl]	[Bank]	[AccountNolbl]	[AccountNo]

[Item List]

Remarks	Amount
Received with thanks from [customer]	[Amt]
TDS deducted	[TDS]
In Words :[rupees]

Prepared by

Counter

[user]

[PrintDate]

[counter]

For [Hospital]
Authorized Signatory