Books of account for doctors under the Income-tax Rules, 2026 Rule 46, the Form No. 25 daily case register, the ₹1,50,000 test and the seven-year rule.

Books of account for doctors are set by section 62 of the Income-tax Act, 2025 and rule 46 of the Income-tax Rules, 2026. A doctor practising on their own account keeps a cash book, a ledger, copies of bills issued, expense bills and vouchers, a daily case register in Form No. 25, and a year-start and year-end inventory of drugs and consumables, and keeps them for seven tax years. A practice whose gross receipts did not exceed ₹1,50,000 in any one of the three previous years is exempt from part of that list. This post walks through each item with the rule number.

A note on sources. The Rules were notified as G.S.R. 198(E) on 20 March 2026 and came into force on 1 April 2026 (rule 1(2)). The Income Tax Department's copy refused our requests on 27 October 2026, so we read the full Gazette PDF from a web archive capture of that same official file taken on 24 March 2026. CBDT's navigator, published with the draft Rules, maps rule 46 to the old Rule 6F. We checked the Income-tax (Fourth Amendment) Rules, 2026 (G.S.R. 822(E), 17 September 2026), which does not touch rule 46; we did not read every earlier amendment, so confirm with your CA that the rule still reads as quoted.

Which law makes a doctor keep books?

Section 62(1)(a) of the Income-tax Act, 2025. It says "any person carrying on specified profession" shall keep and maintain such books of account and other documents as enable the Assessing Officer to compute total income. Section 62(4) defines specified profession as "legal, medical, engineering, architectural, accountancy, technical consultancy, interior decoration, information technology or company secretary". The receipts and income thresholds in section 62(2) (₹1,20,000 of income or ₹10 lakh of receipts, raised to ₹2,50,000 and ₹25 lakh for an individual) apply only to the businesses and other professions in section 62(1)(b). For a doctor, the Act itself sets no threshold.

Section 62(3) leaves the detail to the Board: which books, what they contain, "the form, manner and place" they are kept in, and how long they are retained. The Board did that in rule 46. Section 2(19) of the Act counts "ledgers, day-books, cash books, account-books and other books" as books whether kept in written form or "in electronic or any digital form, or on cloud based storage".

What books does rule 46 list for a doctor?

Rule 46(2) names the medical profession along with legal, engineering, architecture, accountancy, technical consultancy, interior decoration, authorised representatives and film artists, and points to the list in rule 46(4). Rule 46(6) then adds two documents for doctors only. The table puts both together.

Rule 46(4) joins its six items with "or". Read literally that could mean any one of them; the rule then defines the cash book in detail and the vouchers only make sense beside a cash book. Keep each item that fits your practice and ask your CA how the assessing officer reads the list.

What the Form No. 25 daily case register looks like

Form No. 25 is headed "Form of daily case register" and says it is "To be maintained by practitioners of any system of medicine, i.e., physicians, surgeons, dentists, pathologists, radiologists, vaids, hakims, etc." It has six columns:

1. Date.
2. Serial number.
3. Patient's name.
4. Nature of professional services rendered, for example general consultation, surgery, injection, visit.
5. Fees received.
6. Date of receipt.

At most OPD desks this is the register the receptionist already keeps, minus one column: the date the fee was actually received. A patient who pays on a later visit, or a follow-up seen free, needs that column filled honestly. The form asks for nothing clinical; the diagnosis and the prescription do not belong in it. Our post on OPD registers and record-keeping covers the registers other laws ask for, which are different documents.

Is there a receipts limit below which a doctor need not keep books?

Yes, for the rule 46(4) list. Rule 46(3) says sub-rule (2) does not apply in a tax year "if his total gross receipts in the profession do not exceed ₹ 150000 in any one of the three years immediately preceding the tax year", or, where the profession is newly set up in the tax year, if receipts for that year "are not likely to exceed the said amount". A doctor in the first year of an OPD who expects more than ₹1,50,000 of fees is outside the exemption from day one.

The exemption is written for sub-rule (2), which points to the rule 46(4) list. Rule 46(6), the case register and the inventory, is a separate sentence that starts "A person carrying on medical profession shall" and does not refer back to sub-rule (3). Whether a doctor below ₹1,50,000 still keeps Form No. 25 and the inventory is a reading to settle with your CA. The register is one line per patient, so keeping it costs little either way.

Does the presumptive scheme let a doctor skip the books?

Not in so many words, and this is the point to take to your CA. Section 58(2), the presumptive scheme, lets a resident individual or firm in a specified profession declare 50% of gross receipts as profit, if receipts are up to ₹50 lakh, or ₹75 lakh where cash is 5% or less of receipts. Section 63(2) says the tax audit section "shall not apply" where profit is declared as per section 58(2). The Act has a matching sentence for books only for goods carriage operators: section 58(10) switches off sections 62 and 63 for Table serial number 2. We found no such sentence for doctors, and section 62(1)(a) has no exception for the presumptive route.

The other direction is clear. Section 58(3) says a doctor who claims profit lower than 50%, and whose total income exceeds the amount not chargeable to tax, "shall be required to" keep the section 62 books and get the accounts audited under section 63. Section 62(2)(c) and serial number 2 of the table in section 63(1) say the same. Our guide to income tax for doctors under the 2025 Act covers the scheme, the audit and advance tax in full.

Where must the books be kept, and for how long?

Rule 46(7) says the books for the current tax year are kept at the place where the doctor practises; if the doctor practises at more than one place, at the principal place, or at each place if separate books are kept for each. Rule 46(9) sets the retention period: "seven tax years from the end of the relevant tax year". Books for tax year 2026-27, which ends on 31 March 2027, are kept until 31 March 2034. Rule 46(10) adds that if an assessment is reopened, the books held at that time are kept until the reopened assessment is completed.

Patient case records follow different rules and a different clock; see how long to keep medical records.

Can a doctor keep the books in software or on the cloud?

Yes, with a condition. Section 2(19) of the Act accepts books kept "in electronic or any digital form, or on cloud based storage". Rule 46(8) then says books kept in electronic mode "shall remain accessible in India at all times", and the backup "shall be kept on a daily basis in servers physically located in India". If your accounting or billing software keeps your books, ask the vendor in writing where the data and its daily backup sit. A spreadsheet on a laptop with no daily backup does not meet the second half of that sentence.

What happens if a doctor does not keep the books?

Section 441 of the Act allows a penalty of ₹25,000 if a person fails to "keep and maintain the books of account and other documents as per section 62 or the rules made thereunder, in respect of any tax year", or to "retain such books of account and other documents for the period specified in the said rules". The Assessing Officer, the Joint Commissioner (Appeals) or the Commissioner (Appeals) may impose it. The larger cost is usually practical: without books, a doctor who wants to claim actual profit below 50% cannot, because section 58(3) makes books and an audit the price of that claim.

A routine that keeps the books without extra work

1. Every evening, total the day's fees by mode (cash, UPI, card) and write the cash balance. That is the cash book entry rule 46(5)(b) asks for; our post on closing the day at the front desk has the sheet.
2. Keep the OPD list in the Form No. 25 columns: date, serial number, patient's name, service, fee, date received. Fill the date-received column when a due is collected later.
3. Issue a receipt for every fee of ₹250 or more and keep a copy, paper or digital. Our post on what a clinic bill or receipt must include covers the rest of the receipt.
4. File every expense bill of ₹250 or more. For smaller cash expenses with no bill (auto fare, tea for a camp), write and sign a voucher the same day.
5. On 1 April and 31 March, count the drugs, medicines and consumables under broad heads (tablets and syrups, injectables, dressings, disposables) and record quantities and value. Keep the sheet with the year's books.
6. Once a month, send the bundle to your CA; our monthly accounts pack lists what goes in.
7. At year end, box or archive the year's books with the year written on them and a delete-after date seven tax years out.