[Hospital Name]

[HospitalAddress]

RECEIPT VOUCHER
Patient Name [PatientName] Patient ID [Patient ID]
Address [Address] Age/Gender [Age]
PAN No [PAN] MobileNo [Mobile]
Receipt No [rcno]  By Cash/CHQ/DD/Card/Bank [Type]
Receipt Date [rcdate] Customer [Customer]
[depbank lbl] [depbank] [No] [TypeNo]
[Date] [TDATE] [AccountNolbl] [AccountNo]
    [Banklbl] [Bank]
[Item List]
TDS deducted [TDS]
Remarks   Amount
Received with thanks from-[PatientName] [Amt]
In Words :[rupees]
Prepared by Counter

[user]

[PrintDate]

[counter]