Medical Health Bill Template

June 18, 2011

A medical health bill template is a format of a bill given to a patient by a health institute for any medicinal purchase made or any service availed. These types of templates are used in order to evaluate the money that the patient owes.

Sample Medical Health Bill Template

Name of health institute ____________ [The hospital’s name]

Address _____________ [address of the hospital]

Contact no____________ [phone number of hospital]

Name of patient _____________ [patient’s name]

Address ____________ [his address]

Contact no____________ [phone number of patient]

Date of service _dd/mm/yyyy____

Name of service availed _______________ [name of the health service]

Charge for the service _______________ [cost of the service]

Name of medicine purchased _____________ [medicine bought]

Cost _____________ [price of the medicine]

Total charge ____________ [sum total of all charges]

Taxes _____________ [tax to be included]

Signature ____________ [signature of authority in charge]

Seal of health institute ______________ [official seal of the hospital]

Date _dd/mm/yyyy_

Download Medical Health Bill Template in Word Format

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