Payment Receipt - {{ payment_details.receipt

{% if hospital_info.address %}

{% endif %}

{% if hospital_info.phone %}Phone: {{ hospital_info.phone }}{% endif %} {% if hospital_info.email %} | Email: {{ hospital_info.email }}{% endif %} {% if hospital_info.website %} | {{ hospital_info.website }}{% endif %}

PAYMENT RECEIPT

Receipt Information

Receipt Number:	{{ payment_details.receipt_number }}
Payment Date:	{{ payment_details.payment_date\|date:"M d, Y H:i" }}
Print Date:	{{ print_date\|date:"M d, Y H:i" }}
Processed By:	{{ payment_details.processed_by.get_full_name\|default:payment_details.processed_by.username }}

Patient Information

{% if payment_details.patient.phone %} {% endif %} {% if payment_details.patient.email %} {% endif %}

Patient Name:	{{ payment_details.patient.get_full_name }}
Patient ID:	{{ payment_details.patient.patient_id\|default:payment_details.patient.pk }}
Phone:	{{ payment_details.patient.phone }}
Email:	{{ payment_details.patient.email }}

Bill Information

Bill Number:	{{ payment_details.bill.bill_number }}
Bill Date:	{{ payment_details.bill.bill_date\|date:"M d, Y" }}
Due Date:	{{ payment_details.bill.due_date\|date:"M d, Y"\|default:"N/A" }}
Total Bill Amount:	${{ payment_details.bill.total_amount\|floatformat:2 }}
Previous Payments:	${{ payment_details.bill.paid_amount\|floatformat:2\|default:"0.00" }}
Remaining Balance:	${{ payment_details.balance_after_payment\|floatformat:2 }}

Payment Details

{% if payment_details.reference_number %} {% endif %} {% if payment_details.notes %} {% endif %}

Payment Method:	{{ payment_details.payment_method }}
Reference Number:	{{ payment_details.reference_number }}
Notes:	{{ payment_details.notes }}

Amount Paid

${{ payment_details.amount_paid|floatformat:2 }}

✓ Payment Received Successfully

Thank you for your payment. This receipt serves as proof of payment.

Important Notes

Please keep this receipt for your records
This is a computer-generated receipt
For any queries, contact our billing department
Outstanding balance: ${{ payment_details.balance_after_payment|floatformat:2 }}