Create DOR - Portal

Daily Operations Report (DOR)

Create

This Electronic Data is confidential and must not be disclosed, photographed, photocopied, printed, electronically sent, or duplicated without the company’s permission. Violations may lead to disciplinary and legal action.

Header

Date of Sales Report *

Clinic/Branch *

Submitter’s Name *

Patients & Demographics

Old Px

New Px

Demographics

Age Bucket	Count	Spent
16 - 20
21 - 25
26 - 34
35 - 44
45 - 54
55 - 64
65+
NA

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Select all that applies

Cash

Credit Card

Gov’t Expense

Expense

Refund

Cheque

Gift Card

Other Details

Gross Sales *

Cash Left Deposit *

New Deposits *

Net Proceeds *

Old Deposits *

Shortage *

Surgical Amount *

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Credit Card Details

Cards

Creditor	Card Type	Gross Amt	Net Amt

Total Credit Card Gross Sales *

Total Credit Card Net Sales *

Government Expenses *

CC Tax

CC Commission

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Check Details

Checks

Name	Bank	Check No.	Amount	Date

Total Cheque Net Sales *

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Expenses

Particulars	Qty	Amount	Type

Total OLD Expenses

Total NEW Expenses

Total Expenses

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Refunds

Patient	Treatment	Tx Amount	Refunded Amount	ChargeSlip No.

Total Refund Amount *

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

Giftcard Transactions

Giftcards

GC Origin	Issued by	Amount	GC Number

Total Gift Card Amount *

Please add ',' and '.' when needed. Ex: 1,200.00 (no ₱ sign)

E-Signature

By signing this, you agree that the information above is correct and that you accept the confidentiality clause.

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Signed by Automatically copied from “Submitter’s Name”.