A laboratory receipt lists each test a patient paid for, the price and the total, with the lab name and the date. Use the free laboratory receipt maker below. Change the sample tests, add the patient’s name and download the PDF.
What to include on a Laboratory Receipt
- Laboratory name, address and phone
- Patient name
- Each test on its own line with its price
- Referring doctor or hospital, if any
- Total paid and payment method
- Date and receipt number
Example: a filled Laboratory Receipt
The sample receipt lists four common tests: malaria parasite, Widal, full blood count and urinalysis. The "Referred by" box records the doctor or clinic that sent the patient, which many labs need for their records and for HMO claims. Prices vary by lab, so change them to your own.
Common mistakes to avoid
- Writing "lab tests" as one line. List each test. Patients and HMOs need to see what was done.
- No referring doctor. Add the referral when there is one, so the result and receipt go to the right place.
- Results on the receipt. Keep results on your result form. The receipt is only for payment.
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Frequently asked questions
Can I put test results on the receipt?
No. Keep results on your report form. The receipt only shows what was paid.
Can a patient claim this from an HMO?
Most HMOs accept a receipt with the lab name, patient, tests and amount, but some have their own process.
Can I offer a package price?
Yes. Add the package as one line, for example "Pre-employment screening (package)".
Can I issue receipts on my phone at the lab?
Yes. The tool runs in the browser on any phone.
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