1.2.1. DOCTORS REPORT

Appointment

CHOOSE YOUR NAME

“Please indicate whether you referred any patients to another doctor.”

“Any lab expenses or major products purchased today (e.g., implants, derma products, or other medical materials)?”

Total Patients Visited Today & Payments Received

	PATIENT'S NAME	SERVICE	TYPE OF PAYMENT	TOTAL PAID AED
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT

Referral Patients & Total Payment to Other Doctors

	PATIENT'S NAME	SERVICE	TYPE OF PAYMENT	TOTAL PAID AED
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT
PATIENT

Clinic Expenses & Lab Product Costs

	Description	type of payment used	cost
item
item
item
item

Total Income From Referral Patients & Payments to Other Doctors

This field will calculate the total income generated from referral patients and the total amount paid to other doctors. Please ensure all referral payments are entered correctly so the system can produce an accurate final total.

Net Income From Referrals

This field will automatically calculate the net income earned from referral cases, based on the payments recorded for each referred patient. No manual entry is required.

Total Income Collected From All Patients

This field will automatically calculate the total income collected from all patients based on the previous entries. No manual input is required.

Total Expenses

This field will automatically calculate the total expenses based on the previous entries, including lab products and operational costs. No manual input is required.

Pure Net Income

This field will automatically calculate the pure net income after deducting all expenses and applying all relevant totals. No manual input is required.

Your Commission (Auto-Calculated)

This field will automatically calculate your commission after all income and expense details are entered. No manual input is required — the system will generate your final commission amount based on the completed entries.

16teeth

Date

Hour MinutesAM/PM Option

Daily Clinic Income Report – DOCTORS