Rite Aid Receipt Example

An editable Rite Aid receipt example — Prescription Co-Pay, Cold & Flu Relief and 1 more item — coming to $38.76. Use it as a starting point, then edit the items, prices, date and store details to match what you actually bought.

What's on this receipt

ItemQtyPrice
Prescription Co-Pay1$12.00
Cold & Flu Relief1$9.99
Multivitamin 100ct1$14.99
Total (incl. tax)$38.76

This Rite Aid example reflects a credit card purchase in Camp Hill, PA 17011 on 06/15/2026, with sales tax at 4.81%. Yours can use any items, currency, tax rate, date and payment method you like.

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PHARMACY RECEIPT

Rite Aid

910 Health Plaza Drive

Camp Hill, PA 17011

(303) 555-0155

06/15/2026 13:42 · Receipt #920222

RX #7805046
PharmacistOn Duty
PickupReady
ItemQtyPriceTotal
Prescription Co-Pay1$12.00$12.00
Cold & Flu Relief1$9.99$9.99
Multivitamin 100ct1$14.99$14.99
Subtotal$36.98
Sales Tax (4.81%)$1.78
TOTAL$38.76
Payment MethodCredit •••• 4821

Your health, our priority.

920222

Last reviewed