Free tool
Referral letter format for doctors in India. Your case summary, on your letterhead.
Free referral letter maker for Indian doctors: addressee, patient, reason for referral, history, current medicines, urgency, enclosures. Prints A4 or A5.
Letter
Addressed to
Patient
Case summary
Clinic
Logo
Clinic logo only; a photograph of yourself on a letterhead is barred by clause 6.1.2. PNG or JPG, stays in this browser.
Doctor
Layout
Add the doctor's name and registration number to print.
Everything you type is kept only in this browser on this device and is never sent to Vitels. It is not encrypted and anyone using this browser can see it, so press Clear after printing on a shared computer. In the print window choose “Save as PDF” for a file.
Clinic name
Dr. Name
Referral letter
Ref. Date
To
Subject: Referral of the patient
Patient
Age / sex
Clinic ID / OPD no.
Urgency
Dear Doctor,
I am referring the above patient to you for your opinion and further management. A summary of the case follows.
Reason for referral
Relevant history and findings
Current medicines
Enclosures
I would be grateful for your opinion in writing. The patient carries this letter and may be contacted through the clinic.
Place
Confidential. Contains personal health information shared for the patient's care. For the addressed clinician only.
Preview at reduced size. Prints at full A4.
What the regulations say about referring a patient
The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, adopted by the NMC in August 2023, set out how a referral is made and what goes with it.
- 2002 Regulations, clause 3.6
Send a case summary with the patient
"When a patient is referred to a specialist by the attending physician, a case summary of the patient should be given to the specialist, who should communicate his opinion in writing to the attending physician." The letter is that summary; it closes by asking for the opinion in writing.
- 2002 Regulations, clauses 3.1.1 and 3.2
Refer when it is in the patient's interest
In serious illness and in doubtful or difficult conditions the physician should request consultation, but such consultation "should be justifiable and in the interest of the patient only and not for any other consideration." Clause 3.2 adds that in every consultation the benefit to the patient is of foremost importance.
- 2002 Regulations, clause 6.4.1
No commission for the referral
A physician shall not give, solicit or receive "any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient", and shall not take part in fee splitting.
- 2002 Regulations, clauses 1.4.1 and 3.7.2
Registration particulars on the letterhead
Clause 1.4.1 requires the registration number in the clinic and on all prescriptions, certificates and money receipts. Clause 3.7.2 asks for the name, designation and registration particulars on the prescription letterhead. This letter prints on the same letterhead, with your registration number under your name.
- 2002 Regulations, clauses 2.2 and 7.14
What the patient told you stays confidential
Confidences entrusted by patients "should never be revealed unless their revelation is required by the laws of the State." Clause 7.14 lists the exceptions: a court order, a serious and identified risk to a specific person or community, and notifiable diseases. Put in the letter what the specialist needs, and nothing else.
- DPDP Act 2023, sections 7(a) and 8(5); G.S.R. 843(E)
Sharing records under the DPDP Act
Section 7(a) allows processing "for the specified purpose for which the Data Principal has voluntarily provided her personal data", unless she has said she does not consent; section 8(5) requires reasonable security safeguards. Both come into force eighteen months from the 13 November 2025 notification. Hand the letter to the patient or send it on a channel you control.
What a complete referral letter carries
Clause 3.6 asks for a case summary. These are the parts a specialist needs to act on it, in the order they print.
Your letterhead with your name, qualifications and registration number
Date, and a reference number if you keep a referral file
The doctor, department or hospital you are referring to
Patient's name, age, sex and your clinic ID or OPD number
How soon the patient should be seen
The reason for referral: the question you want answered or the care you are handing over
Relevant history and findings, in your words
Current medicines, with generic names and doses
Reports and prescriptions sent with the patient
A request for the specialist's opinion in writing
Your signature
The history is already there in Vitels
In Vitels each patient's visits and prescriptions sit in one record, and prescriptions print on your letterhead with the registration number. Vitels does not make referral letters; this free tool does.
Straight answers
Is there a prescribed format for a referral letter in India?
No form is prescribed. Clause 3.6 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, which the NMC adopted in August 2023, asks only that a case summary go to the specialist and that the specialist reply in writing. The parts in the checklist above are what a specialist needs to act on that summary.
Do I need the patient's consent to send a referral letter?
Clause 2.2 bars revealing confidences unless the law requires it. Agree the referral with the patient and give the letter to the patient to carry, so the patient decides who sees it. When you send it yourself, send only what the specialist needs. The DPDP Act's duties on consent, purpose and security begin eighteen months after 13 November 2025.
Should the letter include the diagnosis?
That is your clinical call; the regulations do not say. Clause 3.6 asks for a case summary, and the tool leaves every clinical field blank so the content is yours alone. Clause 4.3 says the consultant shall discuss the diagnosis and treatment plan with the referring physician.
Can I accept a fee or gift from the hospital I refer to?
No. Clause 6.4.1 of the 2002 regulations bars giving, soliciting or receiving any gift, gratuity, commission or bonus for referring, recommending or procuring a patient, and bars any part in fee splitting. Clause 6.4.2 applies the same rule to referring a person, specimen or material for diagnostic purposes.
Should I keep a copy of the referral letter?
Keep one. The regulations fix a period only for indoor records (three years, clause 1.3.1), but a copy shows what you told the specialist and when, which matters if the case is questioned later. Print twice, or save a PDF from the print window.
Does this tool send the letter or store patient details?
No. It only lays out and prints the letter. Patient details stay in this browser tab for the session and are cleared when you close the tab or press Clear; the letterhead is remembered on this device. Nothing reaches Vitels.
This tool only lays out a letter and fills in nothing clinical. The referring practitioner decides what the letter says and is responsible for it. This page summarises the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 as adopted by the NMC, and the Digital Personal Data Protection Act, 2023; it is general information, not legal advice. Sources read and checked on 26 Oct 2026.