Pharmacy receipt templates
3 templates laid out as pharmacy receipts, each one filled in with a realistic example. Open one, change the details, and download it. For FSA, HSA and insurance claims, which are matched on the prescription line.
3 templatesPNG, JPG, PDFfree to download
CVS Pharmacy Receipt
A pharmacy receipt carrying a logo header, a single line item, a separate tax line and cash tendered with change. Useful when medical spend has to be evidenced across a tax year.
PharmacyUse this template
Pharmacy Receipt
A pharmacy receipt, printed with a logo header, three line items, a separate tax line and a debit card block ending 9074, with a barcode at the foot. Handy as a care record of what was collected, and when.
PharmacyUse this template
Walgreens Receipt
A pharmacy receipt, printed with a logo header, a single line item, a separate tax line and cash tendered with change. Handy as a care record of what was collected, and when.
PharmacyUse this templateWhen a pharmacy receipt is worth having
FSA and HSA claims
Eligible items have to be identifiable on the receipt — prescriptions are listed separately here.
Insurance reimbursement
Insurers ask for the pharmacy, the date, the prescription number and the amount paid.
Medical expense deductions
Keep dated proof of what was spent on medicines across a tax year.
Care records
A clear record of what was collected, and when, for someone else you are caring for.
How to make a pharmacy receipt
Pick a template, change what you need, download it. No account until you download.
Pick a template or start blank
Choose from 189 templates by shop type, or open a blank slip. The template loads straight into the editor with every line already filled in as an example.
Edit the details
Change the business name and address, the date and time, the line items and prices, the tax and total, and the card or cash details. Add or remove sections and drag them into the order you want.
Download it
Export as PNG, JPG or PDF. Downloads are watermark-free and print at true thermal-roll size.
Pharmacy Receipts: questions
What people ask before making a pharmacy receipt.
Should prescription numbers print?
Yes — an Rx number, and often the drug name and quantity. Claims are matched on that number, so it is the one line an insurer looks for.
Can it mix prescriptions with everyday items?
That is how real pharmacy slips read. Keep the prescription lines together at the top, then the shop items below, so eligible spend is easy to pick out.
Is it free to use this template?
Yes. Editing and previewing are free and need no account, and downloads are free too — they just ask you to make an account so your receipts are saved and can be edited later.
Which formats can I download?
PNG, JPG and PDF. PNG is the sharpest for screens, PDF is the one to attach to an expense claim, and JPG is the smallest to send in a message.
Can I change every field?
Every line. The template loads into the editor as a stack of sections — header, date, items, payment, notes — and each one can be edited, reordered, added or removed.
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