Bright Smile Dental Receipt Example
Here's what a Bright Smile Dental receipt looks like: Adult Cleaning (Prophylaxis), Periodic Exam and 1 more item, totalling $240.00. Copy the layout and swap in your own items, prices, date and store details to make one that matches your purchase.
What's on this receipt
| Item | Qty | Price |
|---|---|---|
| Adult Cleaning (Prophylaxis) | 1 | $120.00 |
| Periodic Exam | 1 | $55.00 |
| Bitewing X-rays | 1 | $65.00 |
| Total (incl. tax) | $240.00 | |
This Bright Smile Dental example reflects a credit card purchase in San Jose, CA 95128 on 06/15/2026, with tax at 0%. Yours can use any items, currency, tax rate, date and payment method you like.
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Every field on this receipt is editable in Makecepeit: business name, address, items, quantities, prices, tax, payment method and date. Watch the live preview update as you type, then export a PDF or high-resolution PNG.
SALES RECEIPT
Bright Smile Dental
330 Wellness Avenue
San Jose, CA 95128
(612) 555-0137
06/15/2026 13:42 · Receipt #745321
| Item | Qty | Price | Total |
|---|---|---|---|
| Adult Cleaning (Prophylaxis) | 1 | $120.00 | $120.00 |
| Periodic Exam | 1 | $55.00 | $55.00 |
| Bitewing X-rays | 1 | $65.00 | $65.00 |
Thank you. Please keep this receipt for your records.
745321
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