Pharmacy Receipt Template
A drugstore counter receipt showing a prescription by Rx number alongside over-the-counter items, the way pharmacies protect patient privacy.
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CEDAR POINT PHARMACY
5 Clinic Way
Westbrook, ST 00000
(555) 398-8989
09/07/2026
08:46 AM
| 1 | Rx #77120 — 30 tablets | $12.50 |
| 1 | Cough Syrup 200ml | $7.99 |
| 1 | Hand Sanitizer | $2.99 |
Subtotal$23.48
Tax (4%)$0.94
TOTAL$24.42
CARDVISA ****0000
Pharmacist on duty: ext. 2.
Sample receipt — all business names are fictional.
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