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3 Templates

Pharmacy Receipt Templates

Pharmacy receipts document prescription pickups and over the counter purchases at drugstores. They are commonly required for FSA and HSA reimbursements, insurance claims, and tax records. A typical pharmacy receipt includes prescription details with NDC codes, copay amounts, insurance adjustments, pharmacist information, and pickup date. Our collection has 3 customizable templates from brands like Chemist Warehouse, CVS Health, and Walgreens, each fully editable. Update line items, prices, dates, and store information to match what you need, then download the receipt as a PNG image.

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Shop 14, 415 Victoria Ave Chatswood NSW 2067
(02) 9413 1200
Store: 0281ABN: 53 104 839 621
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24/02/2026, 10:15
Register: 03Trans: 0281-4492
Served by: James T.
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1 Panadol Rapid 20pk$8.99
1 Neutrogena Moisturiser SPF15$14.99
2 Vitamin C 1000mg 60 tabs$19.98
@ $9.99 ea
1 Pantene Shampoo 400ml$5.49
1 Band-Aid Assorted 100pk$7.49
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Subtotal$56.94
Tax (10%)$5.69
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Total$62.63
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EFTPOS Mastercard****8810
Auth#736251
Amount$56.94
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GST INCLUDED IN TOTAL: $5.18 Returns accepted within 30 days with proof of purchase Be Happy. Be Healthy. www.chemistwarehouse.com.au
0281449200030218

Chemist Warehouse Receipt

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1 CVS Dr Woonsocket, RI 02895
(401) 765-1500
Store #3841Pharmacy #3841
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02/24/2026, 04:55 PM
Cashier: Donna R.Register: 4
Trans #: 8837-12
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1 Amoxicillin 500mg 30ct$15.99
1 CVS Ibuprofen 200mg$7.49
1 Flonase Nasal Spray$19.99
1 Band-Aid Assorted 80ct$8.49
2 Vitamin C 1000mg 60ct$25.98
@ $12.99 ea
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Subtotal$77.94
Discount-$8.00
Tax (5%)$3.50
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Total$73.44
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CVS ExtraCare Visa****2091
Auth#483920
Amount$75.20
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ExtraCare Savings Today: $8.00 ExtraBucks Earned: $2.00 Your ExtraBucks expire: 03/31/2026 Thank you for choosing CVS!
3841883712042091

CVS Health Receipt

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200 Wilmot Rd Deerfield, IL 60015
(847) 914-2500
Store #09284Open 24 Hours
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02/24/2026, 08:12 PM
Cashier: Linda T.Reg: 02
myWalgreens #****4182
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1 Lisinopril 10mg 30ct$8.99
1 Nice! Ibuprofen 200mg$6.49
1 CoverGirl Foundation$12.99
1 Colgate Toothpaste 3pk$9.99
2 Emergen-C 30ct$29.98
@ $14.99 ea
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Subtotal$68.44
Discount-$6.00
Tax (5%)$3.12
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Total$65.56
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Visa****8822
Auth#551038
Amount$62.31
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myWalgreens Cash Earned: $0.68 Total myWalgreens Cash: $12.47 Returns within 30 days with receipt. Trusted since 1901.

Walgreens Receipt

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