Running a Clinic

<b>How do you open a clinic in Pakistan?</b> You need a valid PMDC registration, then a licence
from your province's healthcare regulator (PHC in Punjab, SHCC in Sindh, KP HCC, IHRA
in Islamabad). After that, set up suitable premises, arrange medical waste disposal,
register for tax, hire trained staff, and put records, appointments and billing systems in
place before your first patient.&nbsp; &nbsp;<div><br><div>Opening your own clinic is a big moment. Maybe you've just finished your FCPS, or you're
tired of earning for someone else's practice, or you simply want to serve your own
neighbourhood. Whatever the reason, the medicine is the part you already know. The
paperwork, rent negotiations and "which register do we use?" questions are the parts
nobody teaches you.&nbsp; &nbsp;</div></div><div><br></div><div>This checklist puts everything in the right order, so you don't sign a rent agreement for
premises that can't be licensed, or open your doors before your regulator has even
registered you. Each step links to a deeper guide when you need the detail.&nbsp;&nbsp;</div><div><b style="color: rgb(30, 41, 59); font-size: 2rem;"><br></b></div><h2><b style="color: rgb(30, 41, 59); font-size: 2rem;">The 10 steps to open a clinic in Pakistan&nbsp;</b><span style="color: rgb(30, 41, 59); font-size: 2rem; font-weight: 600;">&nbsp;</span></h2><div><br></div><h3><span style="font-weight: normal;">1. Make sure your PMDC registration is valid&nbsp; &nbsp;</span></h3><div>No one can practise without current registration with the Pakistan Medical and Dental
Council. In August 2026, PM&amp;DC directed all doctors and dentists to renew their
registration certificates under the PM&amp;DC Act 2022 within six months <a href="https://pmdc.pk/Documents/press/PM&amp;DC%20Directs%20Doctors%20to%20Renew%20Registration%20Certificates%20to%20Strengthen%20Patient%20Safety,%20Ethical%20Standards%20and%20Prevent%20Misuse.pdf" target="_blank" rel="noopener noreferrer">(PM&amp;DC)</a>. Check
your status first. Every later step asks for it, and an expired registration stalls everything.&nbsp; &nbsp;</div><div><br></div><h3><span style="font-weight: normal;">2. Register with your provincial healthcare commission&nbsp;</span><b> </b>&nbsp;</h3><div><span style="font-size: 0.95rem;">Every clinic must be registered and licensed by the province's healthcare regulator. This
licence covers the premises, separate from your personal PMDC registration. In Punjab,
online registration with PHC is free and a GP clinic's five-year licence costs Rs10,000<a href="https://os.phc.org.pk/licensingfee.aspx" target="_blank" rel="noopener noreferrer">
(PHC)</a>. Start this as soon as you have premises, because registration and licensing take
weeks. See the province-by-province table below.&nbsp; &nbsp;</span></div><div><span style="font-size: 0.95rem;"><br></span></div><div><h3><span style="font-weight: normal;">3. Plan your budget&nbsp;</span></h3></div><div><span style="font-size: 0.95rem;">List your one-time costs (advance rent, renovation, furniture, equipment, licence fee,
signboard) and your monthly costs (rent, salaries, utilities, consumables, software). Keep
at least three to six months of running costs in reserve, because a new clinic takes time to
build regular patients</span><span style="font-size: 0.95rem;">.</span></div><div><br></div><h3><span style="font-weight: normal;">4. Choose the right location and premises&nbsp;</span></h3><div>Look for visibility, parking and a ground floor or lift access for elderly patients. <b>Before you
sign anything</b>,</div><div><ul><li>&nbsp;<b>check two things:
Is medical use allowed at that address?</b> In many residential areas, using a house or flat
as a clinic needs commercial-use approval from the local development authority (such
as LDA, CDA or KDA).&nbsp;</li><li><b>Can the space meet your regulator's standards?</b> You need a waiting area, a
consultation room with privacy, a washroom, and space for waste storage</li></ul><div><br></div></div><h3><span style="font-weight: normal;">5. Set up the space and equipment&nbsp;</span></h3><div>You need a consultation and examination area, a hand-washing point, a sharps box and
colour-coded waste bins, basic diagnostic equipment for your speciality, a fridge for any
vaccines or cold-chain medicines, a UPS for load-shedding, and a fire extinguisher.&nbsp;</div><div><b>Dispensing medicines?</b> If you plan to run a pharmacy counter or medical store with the
clinic, you need a Drug Sale Licence from the district health authority (in Punjab, under
the <a href="https://www.dra.gov.pk/wp-content/uploads/2022/11/Punjab-Drug-Sale-Rules.pdf" target="_blank" rel="noopener noreferrer">Punjab Drug Sale Rules</a>). Check with your district drug inspector before stocking
medicines.</div><div><br></div><h3><span style="font-weight: normal;">6. Register for tax</span></h3><div>&nbsp;Get an NTN if you don't have one and file your income tax return every year to stay on
FBR's Active Taxpayers List. Keep a receipt for every fee from day one. FBR has been
pushing POS e-invoicing for clinics in 2026, and clean billing records will make any future
requirement easy to meet.&nbsp; &nbsp;</div><div><br></div><h3><span style="font-weight: normal;">7. Arrange medical waste disposal</span></h3><div>Clinics produce sharps and infectious waste, and the rules apply to them too. Punjab's
Environmental Protection Department, for example, defines a "hospital" for waste
purposes to include clinics, labs and dispensaries <a href="https://epd.punjab.gov.pk/node/130" target="_blank" rel="noopener noreferrer">(EPD Punjab)</a>. Segregate waste at
source, use a sharps box, and arrange regular collection by an authorised waste
contractor. Keep the receipts, because inspectors ask for them.&nbsp; &nbsp;</div><div><br></div><h3><span style="font-weight: normal;">8. Put your systems in place before day one&nbsp;</span></h3><div>Decide how you'll register patients, give appointments and walk-in tokens, keep records
and prescriptions, and bill. It is far easier to start a new clinic on a proper system than to
move a year of paper registers later. Inspectors will ask to see patient records, and
patients notice a clinic that knows their history.&nbsp; &nbsp;</div><div><br></div><h3><span style="font-weight: normal;">9. Hire and train your staff&nbsp;</span></h3><div>A small clinic usually starts with a receptionist and a nurse or dispenser. Keep copies of
their qualifications and training on file, because regulators check staff credentials. Train
the receptionist properly: they shape the patient's first impression and manage your
queue.&nbsp; &nbsp;</div><div>&nbsp; &nbsp;</div><h3><span style="font-weight: normal;">10. Launch and tell your neighbourhood&nbsp;</span></h3><div>Create your Google Business Profile so patients find you on Maps, put a clear signboard
up with timings, and get a simple clinic web page with booking. Consider a soft launch
week to iron out problems before word spreads. Ask your first happy patients for a
Google review.&nbsp; &nbsp;</div><div><br></div><h2>Which regulator licenses your clinic?&nbsp;</h2><div><b>It depends on where the clinic is</b>. Each province has its own healthcare regulator, and the
licence is for the premises, on top of your PMDC registration.&nbsp;&nbsp;</div><div>&nbsp; &nbsp;</div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td>

Where

</td><td>

Regulator

</td><td>

What to know

</td></tr><tr><td>

Punjab

</td><td>

Punjab Healthcare Commission
(PHC)


</td><td>

Free online registration; licence
valid 5 years; GP clinic fee
Rs10,000 <a href="https://www.phc.org.pk/#/licensing/home#licensingFee" target="_blank" rel="noopener noreferrer">(PHC)</a>


</td></tr><tr><td>

Sindh

</td><td>

Sindh Healthcare Commission
(SHCC)


</td><td>

Online registration and licensing
for private clinics, launched June
2025 through the Sindh Business
One Stop Shop <a href="https://bloompakistan.com/sindh-launches-online-health-facility-registration/" target="_blank" rel="noopener noreferrer">(Bloom Pakistan)</a>

</td></tr><tr><td>

Khyber
Pakhtunkhwa


</td><td>

KP Health Care Commission

</td><td>

Over 21,000 facilities registered;
1,650 sealed in three months of
inspections in late 2025 <a href="https://www.app.com.pk/domestic/kp-healthcare-commission-inspects-7544-medical-centers-1650-sealed-in-three-months/" target="_blank" rel="noopener noreferrer">(APP)</a>


</td></tr><tr><td>

Islamabad (ICT)

</td><td>

Islamabad Healthcare Regulatory
Authority (IHRA)


</td><td>

Licence forms published on
<a href="https://ihra.gov.pk/" target="_blank" rel="noopener noreferrer">IHRA's website</a>


</td></tr><tr><td>

Balochistan

</td><td>

Balochistan Healthcare
Commission

</td><td>

Registration form published by
the provincial health department<a href="https://health.balochistan.gov.pk/wp-content/uploads/2025/07/Registration-form-Balochistan-Healthcare-Commission.pdf" target="_blank" rel="noopener noreferrer">
(form, PDF)</a>


</td></tr></tbody></table></div><div>&nbsp;</div><div>Enforcement is real in every province. Regulators seal unregistered facilities in regular
drives, so register before you open, not after.</div><h2><b>Opening-day checklist</b></h2><div>
Print this and tick it off in the week before you open.

</div><h3>&nbsp;<b> Paperwork</b></h3><div><ul><li>

PMDC registration valid for every doctor</li><li>Healthcare commission registration done (and licence applied for)&nbsp;</li><li>Rent agreement or ownership papers, and commercial-use approval if needed&nbsp;</li><li>NTN in place&nbsp;</li><li>Waste collection arranged with an authorised contractor&nbsp;</li><li>Drug Sale Licence, if you dispense medicines</li><li>&nbsp;Staff qualification copies on file&nbsp;</li></ul></div><h3>&nbsp;<b>

Premises and equipment

</b></h3><div><ul><li><span style="font-size: 0.95rem;">&nbsp; Waiting area with seating and a visible fee and timings board</span></li><li><span style="font-size: 0.95rem;">&nbsp; Consultation room with a curtain or door for privacy&nbsp;</span></li><li><span style="font-size: 0.95rem;">&nbsp; Hand-washing point, sharps box and colour-coded waste bins</span></li><li><span style="font-size: 0.95rem;">&nbsp; Examination couch and the core equipment for your speciality&nbsp;</span></li><li><span style="font-size: 0.95rem;">&nbsp; UPS or backup power for lights, computer and printer&nbsp;</span></li></ul><ul><li><span style="font-size: 0.95rem;">&nbsp; Fire extinguisher and a first-aid / emergency tray&nbsp; &nbsp; &nbsp;</span></li></ul></div><h3>&nbsp; <b>Systems</b>&nbsp;&nbsp;</h3><div><ul><li><span style="font-size: 0.95rem;">&nbsp; Patient registration and record system ready&nbsp;</span></li><li><span style="font-size: 0.95rem;">&nbsp; Appointment and walk-in token method decided&nbsp;</span></li><li><span style="font-size: 0.95rem;">&nbsp; Prescription format (printed, with Urdu dosage instructions)</span></li><li><span style="font-size: 0.95rem;">&nbsp; Receipt for every fee&nbsp;</span></li></ul><ul><li><span style="font-size: 0.95rem;">&nbsp; Google Business Profile live on Maps&nbsp;&nbsp;</span></li></ul><h2><b>Register or software: choose your system on day one&nbsp; &nbsp;</b></h2></div><div><b>A new clinic is the cheapest moment to start on software</b>. There is no backlog of paper
records to move, and your staff learn one way of working from the start.&nbsp; &nbsp;<b></b></div><div><br></div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td>

Task

</td><td>

Paper register 

</td><td>

Clinic software

</td></tr><tr><td>

Find a returning patient's
history

</td><td>

Flip through months of
pages


</td><td>

Search by name or phone in
seconds


</td></tr><tr><td>

Walk-in queue 

</td><td>

Shouting names, "kis ka
number hai?"

</td><td>

Numbered tokens in order

</td></tr><tr><td>

Prescriptions

</td><td>

Handwritten, hard to read 

</td><td>

Printed, with dosage
instructions in Urdu


</td></tr><tr><td>

Fees and daily total 

</td><td>

Cash book, totalled at night 

</td><td>

Receipt per patient, totals
automatic


</td></tr><tr><td>

Inspection day 

</td><td>

Hunting for missing pages 

</td><td>

Records ready to show


</td></tr><tr><td>

Cost

</td><td>

Low upfront, high in staff
time

</td><td>

Monthly fee

</td></tr></tbody></table></div><div><br></div><div><b>Starting a new clinic? Start it organised.</b> ClinicNex AI gives you patient records,&nbsp;<span style="font-size: 0.95rem;">appointments, printed prescriptions and PKR billing from your very first patient, at PKR&nbsp;</span><span style="font-size: 0.95rem;">10,000 a month for the whole clinic, with unlimited doctors. <a href="https://clinicnexai.com/register" target="_blank" rel="noopener noreferrer"><u>Start your 7-day free trial</u></a> or&nbsp;</span><span style="font-size: 0.95rem;">book a free demo.</span></div><div><br></div><div><br></div><div><br></div>

Opening a clinic in Pakistan? The 10 steps in order: PMDC, healthcare commission licence, premises, waste, staff, systems and launch, by province.

How to Start a Clinic in Pakistan: 10-Step Checklist (2026)

<p>If you run a clinic, you have probably heard three different versions of this story in your&#xa0; <span style="font-size: 0.95rem;">doctors&apos; WhatsApp group this month. Some say POS machines are compulsory from&#xa0;</span> <span style="font-size: 0.95rem;">tomorrow. Others say the PMA has stopped it. The truth sits in between, and it matters,</span> because the doctors who prepare calmly now will have the easiest switch if the rule is&#xa0;<span style="font-size: 0.95rem;">finalised.</span></p><div><br></div><div>This guide explains what FBR has actually proposed, who it covers, what has happened&#xa0;<span style="font-size: 0.95rem;">since, and the practical steps worth taking this month, whatever the final outcome.</span></div><div><br></div><blockquote>Note: This is general information, not tax advice. Rules can change quickly; check&#xa0;<span style="font-size: 0.95rem;">FBR&apos;s latest notifications or speak to your tax adviser before acting.</span></blockquote><div><br></div><h2><b>What does FBR POS integration mean for a clinic?</b></h2><div>In simple terms, <b>every fee your clinic collects would go through billing software&#xa0;</b><b style="font-size: 0.95rem;">connected to FBR</b><span style="font-size: 0.95rem;">, and every patient would get a computer-generated receipt that FBR&#xa0;</span><span style="font-size: 0.95rem;">can verify. It is about documenting income for </span><b style="font-size: 0.95rem;">income tax</b><span style="font-size: 0.95rem;">. It is not a new sales tax on&#xa0;</span><span style="font-size: 0.95rem;">patients: sales tax on services is a provincial matter, and doctors don&apos;t charge it on</span></div><div>consultations.</div><div><br></div><div>Based on the draft as reported, an integrated clinic would need to:</div><div><br></div><div>1. <b>Register its premises</b> (each &quot;outlet&quot; or point of sale) on FBR&apos;s online system.</div><div>2.<b> Install POS or e-invoicing software</b> from an FBR-licensed integrator, at the clinic&apos;s own cost</div><div>3. <b>Bill every service through it</b>. Supplies must be made only through the integrated&#xa0;<span style="font-size: 0.95rem;">system.</span></div><div>4. <b>Give each patient an e-receipt</b> with a unique FBR invoice number and a QR code the&#xa0;<span style="font-size: 0.95rem;">patient can scan to verify.</span></div><div>5. <b>Send transaction data to FBR in real time.</b> If the internet or power fails, sales must be&#xa0;<span style="font-size: 0.95rem;">uploaded within a set time once it&apos;s back.</span></div><div>6. <b>Keep records for at least six years.</b></div><div>7. <b>Display a signboard</b> at the premises showing the FBR logo and the integration status.&#xa0;</div><div><span style="font-size: 0.95rem;"><br></span></div><div><span style="font-size: 0.95rem;"></span></div><p>Card machines and other digital payment channels may also need to be linked.</p><div><br></div><div><b>What changes day to day</b></div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td><br></td><td>Most clinics today&#xa0;</td><td>Under FBR POS</td></tr><tr><td>Receipt&#xa0;</td><td>Handwritten parchi, or none<br></td><td>Printed e-receipt with FBR invoice number + QR code<br></td></tr><tr><td>Fee record</td><td>Register or cash book&#xa0;</td><td>Software that reports each bill to FBR<br></td></tr><tr><td>Internet</td><td>Optional</td><td>Needed, with catch-up upload after outages<br></td></tr><tr><td>Record keeping</td><td>Varies</td><td>At least 6 years</td></tr><tr><td>Cost</td><td>None</td><td>Software, printer and integration, paid by the clinic</td></tr></tbody></table><br></div><div><b>What it is not about: patient details.</b> The reported requirements concern the bill (the&#xa0;<span style="font-size: 0.95rem;">amount and the service), not the medical record. Doctors&apos; associations have raised&#xa0;</span><span style="font-size: 0.95rem;">patient-privacy concerns, so keep receipts generic, for example &quot;Consultation&quot; or&#xa0;</span><span style="font-size: 0.95rem;">&quot;Follow-up visit&quot;, and never print a diagnosis on an invoice.</span></div><div><br></div><h2><b>Which clinics and medical services are covered?</b></h2><div>The draft is broad: news reports of SRO 288(I)/2026 describe it as covering &quot;all medical&#xa0;<span style="font-size: 0.95rem;">service providers&quot;, then name specific groups. If you see patients for a fee, assume you&#xa0;</span><span style="font-size: 0.95rem;">are in scope until the final text says otherwise.</span></div><div><br></div><div><ul><li>Private clinics and medical practitioners, both GPs and specialists</li><li>Dentists and dental clinics</li><li>Physiotherapists</li><li>Plastic surgeons and hair transplant clinics</li><li>Diagnostic and pathology labs, including X-ray, CT and MRI centres</li><li>Private hospitals and medical care centres</li><li>Veterinary doctors (<a href="https://www.brecorder.com/news/40407975" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Business Recorder</a><span style="font-size: 0.95rem;">, </span><a href="https://profit.pakistantoday.com.pk/2026/02/19/fbr-directs-integration-of-e-invoicing-with-income-tax-system-for-specified-businesses" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Profit</a><span style="font-size: 0.95rem;">)</span></li></ul></div><div><b>Who might be exempt? </b>Two exemptions have been reported, but neither is confirmed in a&#xa0;<span style="font-size: 0.95rem;">final text:</span></div><div><ul><li><b>Private hospitals charging a consultation fee below Rs500</b> are reported as exempt (<a href="https://www.geo.tv/latest/651975-fbr-orders-installation-of-pos-system-in-over-14-sectors" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Geo News</a><span style="font-size: 0.95rem;">, </span><a href="https://dunyanews.tv/en/Business/936541-fbr-enforces-nationwide-digital-monitoring-for-hotels-clinics-and-lei" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Dunya News</a><span style="font-size: 0.95rem;">)</span></li><li><span style="font-size: 0.95rem;">Small businesses with low electricity use or minimal fees may be exempt, according&#xa0;</span>to the draft as reported by <a href="https://tribune.com.pk/story/2593493/fbr-unveils-draft-amendments-to-income-tax-rules-mandates-pos-integration-for-businesses" target="_blank" rel="noopener noreferrer">The Express Tribune</a></li></ul></div><div><b>Still unclear</b>: whether a clear threshold will protect small one-doctor clinics, how doctors&#xa0;<span style="font-size: 0.95rem;">who consult at several clinics will be treated, and what the deadline will be. Treat any&#xa0;</span><span style="font-size: 0.95rem;">WhatsApp forward that gives a firm answer to these with caution.</span></div><div><br></div><h2><b>Why is FBR doing this, and where do things stand?</b></h2><div>FBR&apos;s own figures explain its focus on doctors. In December 2025 it said that of <b>130,243</b></div><div><b>registered doctors, only 56,287 had filed income tax returns</b>, and 31,870 declared zero</div><div>income from private practice <a href="https://tribune.com.pk/story/2581993/fbr-to-move-against-private-clinics-hospitals-over-tax-evasion-underreporting" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a>. POS integration is its way of</div><div>documenting fees at source. Doctors&apos; associations argue that clinics are not retail shops,</div><div>that the system adds cost for small practices, and that it risks patient confidentiality.</div><div><br></div><div><b>Where things stand (19 October 2026</b>):&#xa0;</div><div>we could not find a final, gazetted notification or&#xa0;<span style="font-size: 0.95rem;">a compliance deadline for clinics in public reports. The PMA&apos;s opposition is ongoing, and&#xa0;</span><span style="font-size: 0.95rem;">provincial tax authorities have also objected. Details, such as any threshold for small</span></div><div>clinics, may still change before anything is enforced.</div><div><br></div><div><b>What has happened so far (newest first)</b></div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td>Date</td><td>What happened<br></td></tr><tr><td>1 Oct 2026</td><td>PIMA rejects the POS push: &quot;clinics and hospitals were not supermarkets&quot; <a href="https://tribune.com.pk/story/2632374/clinics-are-not-retail-shops-pima-rejects-fbrs-pos-push" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a><br><br></td></tr><tr><td>30 Sep 2026</td><td>PMA&apos;s symbolic strike at clinics and private hospitals against POS and Section 175C proceedings <a href="https://propakistani.pk/2026/09/28/pma-announces-symbolic-strike-against-fbrs-pos-measures/" target="_blank" rel="noopener noreferrer">(ProPakistani)</a></td></tr><tr><td>24 Jul 2026</td><td>After meeting the FBR chairman, PMA warns of nationwide clinic closures if POS is imposed<br><a href="https://profit.pakistantoday.com.pk/2026/07/24/pakistan-medical-association-threatens-nationwide-clinic-closures-over-fbr-point-of-sale-requirement" target="_blank" rel="noopener noreferrer">(Profit)</a><br><br></td></tr><tr><td>11 Mar 2026</td><td>Sindh Revenue Board and Balochistan Revenue Authority object, saying many services already link<br>to provincial POS systems, and ask FBR not to finalise without consultation<a href="https://profit.pakistantoday.com.pk/2026/03/11/provincial-tax-authorities-oppose-fbrs-move-to-link-service-providers-to-federal-pos-e-invoicing-system" target="_blank" rel="noopener noreferrer"> (Profit)</a><br><br></td></tr><tr><td>24 Feb 2026</td><td>PMA Punjab rejects the SRO over cost and patient privacy concerns <a href="https://www.24newshd.tv/24-Feb-2026/fbr-urged-reconsider-pos-implementation-private-healthcare-sector" target="_blank" rel="noopener noreferrer">(24 News HD)</a></td></tr><tr><td>18 Feb 2026</td><td>FBR issues SRO 288(I)/2026 as draft amendments to the income tax rules, with a short window for public comments <a href="https://tribune.com.pk/story/2593493/fbr-unveils-draft-amendments-to-income-tax-rules-mandates-pos-integration-for-businesses" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a></td></tr><tr><td>18 Jan 2026</td><td>PMA Rawalpindi asks the government to review POS in clinics <a href="https://www.app.com.pk/?p=1147906" target="_blank" rel="noopener noreferrer">(APP)</a></td></tr></tbody></table><br></div><h2><b>What should doctors do now? An 8-step checklist</b></h2><div><b><br></b></div><div>You don&apos;t need to buy a POS machine today. But a few low-cost habits will protect you&#xa0;<span style="font-size: 0.95rem;">whatever FBR finally decides, and they make a future switch painless.</span></div><div><br></div><div>1. <b>Check the facts at the source.</b> Look at the notifications section of <a href="https://www.fbr.gov.pk/" target="_blank" rel="noopener noreferrer">fbr.gov.pk</a> or ask&#xa0;<span style="font-size: 0.95rem;">your tax adviser before acting on a WhatsApp forward.</span></div><div>2. <b>Make sure you file your income tax return</b>. Staying on FBR&apos;s Active Taxpayers List is&#xa0;<span style="font-size: 0.95rem;">your best protection, and non-filers are FBR&apos;s first target.</span></div><div>3. <b>Give a numbered receipt for every fee, starting now</b>. Even a simple printed receipt&#xa0;<span style="font-size: 0.95rem;">builds the habit and the records FBR will expect.</span></div><div>4. <b>Keep medical details off receipts</b>. Write &quot;Consultation&quot; or &quot;Procedure&quot;, never the&#xa0;<span style="font-size: 0.95rem;">diagnosis. Your patients&apos; privacy stays protected under any system.</span></div><div>5. <b>Close the day with a tally</b>. Count patients and fees each evening and match them&#xa0;<span style="font-size: 0.95rem;">against cash and digital payments. Gaps are easier to fix daily than at tax time.</span></div><div>6. <b>Plan for power and internet</b>. Real-time reporting needs a UPS for the computer and&#xa0;<span style="font-size: 0.95rem;">printer, plus a backup mobile internet device. Load-shedding shouldn&apos;t stop your OPD.</span></div><div>7. <b>Ask your software provider three questions</b>: Will you integrate with FBR once the&#xa0;<span style="font-size: 0.95rem;">rules are final? Through an FBR-licensed integrator? Will billing still work offline and&#xa0;</span><span style="font-size: 0.95rem;">sync later?</span></div><div>8. <b>Follow your association.</b> PMA and your provincial chapter are negotiating on doctors&apos;&#xa0;<span style="font-size: 0.95rem;">behalf, so watch their updates for changes in scope or deadlines.</span></div><div><br></div><div>If you already use clinic software, steps 3 to 5 may be covered. ClinicNex AI, for example,&#xa0;<span style="font-size: 0.95rem;"><a href="/#features">issues a PKR invoice for every visit</a> and shows the day&apos;s totals in its reports. If you&apos;re still&#xa0;</span><span style="font-size: 0.95rem;">on a register, this is a good time to move your billing to a system, whatever the final rule&#xa0;</span><span style="font-size: 0.95rem;">says.</span></div><div><br></div><div>Get your clinic&apos;s billing ready, whatever FBR decides. ClinicNex AI gives every patient a&#xa0;<span style="font-size: 0.95rem;">proper PKR invoice, keeps your records organised and shows your daily totals in one&#xa0;</span><span style="font-size: 0.95rem;">place, from PKR 10,000 a month with unlimited doctors. </span><a href="https://clinicnexai.com/" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;"></a><a href="https://clinicnexai.com/register" target="_blank" rel="noopener noreferrer">Start your 7-day free trial</a><span style="font-size: 0.95rem;"> or book&#xa0;</span><span style="font-size: 0.95rem;">a free demo.&#xa0;</span><span style="font-size: 0.95rem;"><a href="https://clinicnexai.com/blog/how-to-start-a-clinic-in-pakistan" target="_blank" rel="noopener noreferrer">Opening
a new clinic? See our 10-step guide</a></span></div><div>&#xa0;&#xa0;</div><div>About the author: Sohail Anwar writes about running clinics in Pakistan for ClinicNex AI.&#xa0;<span style="font-size: 0.95rem;">This article is general information, not tax or&#xa0;</span><span style="font-size: 0.95rem;">legal advice.</span></div>

FBR has listed clinics, labs and doctors for POS e-invoicing. What's confirmed, what isn't, and 8 practical steps to take now. Updated October 2026.

FBR POS for Clinics Explained: Who's Covered and What Doctors Should Do Now

FBR POS for Clinics in Pakistan: What Doctors Must Know

Clinic Management / Regulations

<p><b>Do clinics in Pakistan have to install an FBR POS system?</b>  FBR wants them to. In February&#xa0; <span style="font-size: 0.95rem;">2026 it issued SRO 288(I)/2026, which says doctors, clinics, labs and private hospitals&#xa0;</span> <span style="font-size: 0.95rem;">must link their billing to FBR&apos;s system and issue e-receipts with an FBR invoice number&#xa0;</span> <span style="font-size: 0.95rem;">and QR code. It was issued as a draft, and doctors&apos; bodies are opposing it. As of today, we&#xa0;</span> <span style="font-size: 0.95rem;">could not find a final notification or compliance deadline.&#xa0;</span><span style="font-size: 0.95rem;"></span></p><p>If you run a clinic, you have probably heard three different versions of this story in your&#xa0; <span style="font-size: 0.95rem;">doctors&apos; WhatsApp group this month. Some say POS machines are compulsory from&#xa0;</span> <span style="font-size: 0.95rem;">tomorrow. Others say the PMA has stopped it. The truth sits in between, and it matters,</span> because the doctors who prepare calmly now will have the easiest switch if the rule is&#xa0;<span style="font-size: 0.95rem;">finalised.</span></p><div><br></div><div>This guide explains what FBR has actually proposed, who it covers, what has happened&#xa0;<span style="font-size: 0.95rem;">since, and the practical steps worth taking this month, whatever the final outcome.</span></div><div><br></div><blockquote>Note: This is general information, not tax advice. Rules can change quickly; check&#xa0;<span style="font-size: 0.95rem;">FBR&apos;s latest notifications or speak to your tax adviser before acting.</span></blockquote><div><br></div><h2><b>What does FBR POS integration mean for a clinic?</b></h2><div>In simple terms, <b>every fee your clinic collects would go through billing software&#xa0;</b><b style="font-size: 0.95rem;">connected to FBR</b><span style="font-size: 0.95rem;">, and every patient would get a computer-generated receipt that FBR&#xa0;</span><span style="font-size: 0.95rem;">can verify. It is about documenting income for </span><b style="font-size: 0.95rem;">income tax</b><span style="font-size: 0.95rem;">. It is not a new sales tax on&#xa0;</span><span style="font-size: 0.95rem;">patients: sales tax on services is a provincial matter, and doctors don&apos;t charge it on</span></div><div>consultations.</div><div><br></div><div>Based on the draft as reported, an integrated clinic would need to:</div><div><br></div><div>1. <b>Register its premises</b> (each &quot;outlet&quot; or point of sale) on FBR&apos;s online system.</div><div>2.<b> Install POS or e-invoicing software</b> from an FBR-licensed integrator, at the clinic&apos;s own cost</div><div>3. <b>Bill every service through it</b>. Supplies must be made only through the integrated&#xa0;<span style="font-size: 0.95rem;">system.</span></div><div>4. <b>Give each patient an e-receipt</b> with a unique FBR invoice number and a QR code the&#xa0;<span style="font-size: 0.95rem;">patient can scan to verify.</span></div><div>5. <b>Send transaction data to FBR in real time.</b> If the internet or power fails, sales must be&#xa0;<span style="font-size: 0.95rem;">uploaded within a set time once it&apos;s back.</span></div><div>6. <b>Keep records for at least six years.</b></div><div>7. <b>Display a signboard</b> at the premises showing the FBR logo and the integration status.&#xa0;</div><div><span style="font-size: 0.95rem;"><br></span></div><div><span style="font-size: 0.95rem;"></span></div><p>Card machines and other digital payment channels may also need to be linked.</p><div><br></div><div><b>What changes day to day</b></div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td><br></td><td>Most clinics today&#xa0;</td><td>Under FBR POS</td></tr><tr><td>Receipt&#xa0;</td><td>Handwritten parchi, or none<br></td><td>Printed e-receipt with FBR invoice number + QR code<br></td></tr><tr><td>Fee record</td><td>Register or cash book&#xa0;</td><td>Software that reports each bill to FBR<br></td></tr><tr><td>Internet</td><td>Optional</td><td>Needed, with catch-up upload after outages<br></td></tr><tr><td>Record keeping</td><td>Varies</td><td>At least 6 years</td></tr><tr><td>Cost</td><td>None</td><td>Software, printer and integration, paid by the clinic</td></tr></tbody></table><br></div><div><b>What it is not about: patient details.</b> The reported requirements concern the bill (the&#xa0;<span style="font-size: 0.95rem;">amount and the service), not the medical record. Doctors&apos; associations have raised&#xa0;</span><span style="font-size: 0.95rem;">patient-privacy concerns, so keep receipts generic, for example &quot;Consultation&quot; or&#xa0;</span><span style="font-size: 0.95rem;">&quot;Follow-up visit&quot;, and never print a diagnosis on an invoice.</span></div><div><br></div><h2><b>Which clinics and medical services are covered?</b></h2><div>The draft is broad: news reports of SRO 288(I)/2026 describe it as covering &quot;all medical&#xa0;<span style="font-size: 0.95rem;">service providers&quot;, then name specific groups. If you see patients for a fee, assume you&#xa0;</span><span style="font-size: 0.95rem;">are in scope until the final text says otherwise.</span></div><div><br></div><div><ul><li>Private clinics and medical practitioners, both GPs and specialists</li><li>Dentists and dental clinics</li><li>Physiotherapists</li><li>Plastic surgeons and hair transplant clinics</li><li>Diagnostic and pathology labs, including X-ray, CT and MRI centres</li><li>Private hospitals and medical care centres</li><li>Veterinary doctors (<a href="https://www.brecorder.com/news/40407975" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Business Recorder</a><span style="font-size: 0.95rem;">, </span><a href="https://profit.pakistantoday.com.pk/2026/02/19/fbr-directs-integration-of-e-invoicing-with-income-tax-system-for-specified-businesses" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Profit</a><span style="font-size: 0.95rem;">)</span></li></ul></div><div><b>Who might be exempt? </b>Two exemptions have been reported, but neither is confirmed in a&#xa0;<span style="font-size: 0.95rem;">final text:</span></div><div><ul><li><b>Private hospitals charging a consultation fee below Rs500</b> are reported as exempt (<a href="https://www.geo.tv/latest/651975-fbr-orders-installation-of-pos-system-in-over-14-sectors" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Geo News</a><span style="font-size: 0.95rem;">, </span><a href="https://dunyanews.tv/en/Business/936541-fbr-enforces-nationwide-digital-monitoring-for-hotels-clinics-and-lei" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;">Dunya News</a><span style="font-size: 0.95rem;">)</span></li><li><span style="font-size: 0.95rem;">Small businesses with low electricity use or minimal fees may be exempt, according&#xa0;</span>to the draft as reported by <a href="https://tribune.com.pk/story/2593493/fbr-unveils-draft-amendments-to-income-tax-rules-mandates-pos-integration-for-businesses" target="_blank" rel="noopener noreferrer">The Express Tribune</a></li></ul></div><div><b>Still unclear</b>: whether a clear threshold will protect small one-doctor clinics, how doctors&#xa0;<span style="font-size: 0.95rem;">who consult at several clinics will be treated, and what the deadline will be. Treat any&#xa0;</span><span style="font-size: 0.95rem;">WhatsApp forward that gives a firm answer to these with caution.</span></div><div><br></div><h2><b>Why is FBR doing this, and where do things stand?</b></h2><div>FBR&apos;s own figures explain its focus on doctors. In December 2025 it said that of <b>130,243</b></div><div><b>registered doctors, only 56,287 had filed income tax returns</b>, and 31,870 declared zero</div><div>income from private practice <a href="https://tribune.com.pk/story/2581993/fbr-to-move-against-private-clinics-hospitals-over-tax-evasion-underreporting" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a>. POS integration is its way of</div><div>documenting fees at source. Doctors&apos; associations argue that clinics are not retail shops,</div><div>that the system adds cost for small practices, and that it risks patient confidentiality.</div><div><br></div><div><b>Where things stand (19 October 2026</b>):&#xa0;</div><div>we could not find a final, gazetted notification or&#xa0;<span style="font-size: 0.95rem;">a compliance deadline for clinics in public reports. The PMA&apos;s opposition is ongoing, and&#xa0;</span><span style="font-size: 0.95rem;">provincial tax authorities have also objected. Details, such as any threshold for small</span></div><div>clinics, may still change before anything is enforced.</div><div><br></div><div><b>What has happened so far (newest first)</b></div><div><table style="border: 1px solid rgb(204, 204, 204);"><tbody><tr><td>Date</td><td>What happened<br></td></tr><tr><td>1 Oct 2026</td><td>PIMA rejects the POS push: &quot;clinics and hospitals were not supermarkets&quot; <a href="https://tribune.com.pk/story/2632374/clinics-are-not-retail-shops-pima-rejects-fbrs-pos-push" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a><br><br></td></tr><tr><td>30 Sep 2026</td><td>PMA&apos;s symbolic strike at clinics and private hospitals against POS and Section 175C proceedings <a href="https://propakistani.pk/2026/09/28/pma-announces-symbolic-strike-against-fbrs-pos-measures/" target="_blank" rel="noopener noreferrer">(ProPakistani)</a></td></tr><tr><td>24 Jul 2026</td><td>After meeting the FBR chairman, PMA warns of nationwide clinic closures if POS is imposed<br><a href="https://profit.pakistantoday.com.pk/2026/07/24/pakistan-medical-association-threatens-nationwide-clinic-closures-over-fbr-point-of-sale-requirement" target="_blank" rel="noopener noreferrer">(Profit)</a><br><br></td></tr><tr><td>11 Mar 2026</td><td>Sindh Revenue Board and Balochistan Revenue Authority object, saying many services already link<br>to provincial POS systems, and ask FBR not to finalise without consultation<a href="https://profit.pakistantoday.com.pk/2026/03/11/provincial-tax-authorities-oppose-fbrs-move-to-link-service-providers-to-federal-pos-e-invoicing-system" target="_blank" rel="noopener noreferrer"> (Profit)</a><br><br></td></tr><tr><td>24 Feb 2026</td><td>PMA Punjab rejects the SRO over cost and patient privacy concerns <a href="https://www.24newshd.tv/24-Feb-2026/fbr-urged-reconsider-pos-implementation-private-healthcare-sector" target="_blank" rel="noopener noreferrer">(24 News HD)</a></td></tr><tr><td>18 Feb 2026</td><td>FBR issues SRO 288(I)/2026 as draft amendments to the income tax rules, with a short window for public comments <a href="https://tribune.com.pk/story/2593493/fbr-unveils-draft-amendments-to-income-tax-rules-mandates-pos-integration-for-businesses" target="_blank" rel="noopener noreferrer">(The Express Tribune)</a></td></tr><tr><td>18 Jan 2026</td><td>PMA Rawalpindi asks the government to review POS in clinics <a href="https://www.app.com.pk/?p=1147906" target="_blank" rel="noopener noreferrer">(APP)</a></td></tr></tbody></table><br></div><h2><b>What should doctors do now? An 8-step checklist</b></h2><div><b><br></b></div><div>You don&apos;t need to buy a POS machine today. But a few low-cost habits will protect you&#xa0;<span style="font-size: 0.95rem;">whatever FBR finally decides, and they make a future switch painless.</span></div><div><br></div><div>1. <b>Check the facts at the source.</b> Look at the notifications section of <a href="https://www.fbr.gov.pk/" target="_blank" rel="noopener noreferrer">fbr.gov.pk</a> or ask&#xa0;<span style="font-size: 0.95rem;">your tax adviser before acting on a WhatsApp forward.</span></div><div>2. <b>Make sure you file your income tax return</b>. Staying on FBR&apos;s Active Taxpayers List is&#xa0;<span style="font-size: 0.95rem;">your best protection, and non-filers are FBR&apos;s first target.</span></div><div>3. <b>Give a numbered receipt for every fee, starting now</b>. Even a simple printed receipt&#xa0;<span style="font-size: 0.95rem;">builds the habit and the records FBR will expect.</span></div><div>4. <b>Keep medical details off receipts</b>. Write &quot;Consultation&quot; or &quot;Procedure&quot;, never the&#xa0;<span style="font-size: 0.95rem;">diagnosis. Your patients&apos; privacy stays protected under any system.</span></div><div>5. <b>Close the day with a tally</b>. Count patients and fees each evening and match them&#xa0;<span style="font-size: 0.95rem;">against cash and digital payments. Gaps are easier to fix daily than at tax time.</span></div><div>6. <b>Plan for power and internet</b>. Real-time reporting needs a UPS for the computer and&#xa0;<span style="font-size: 0.95rem;">printer, plus a backup mobile internet device. Load-shedding shouldn&apos;t stop your OPD.</span></div><div>7. <b>Ask your software provider three questions</b>: Will you integrate with FBR once the&#xa0;<span style="font-size: 0.95rem;">rules are final? Through an FBR-licensed integrator? Will billing still work offline and&#xa0;</span><span style="font-size: 0.95rem;">sync later?</span></div><div>8. <b>Follow your association.</b> PMA and your provincial chapter are negotiating on doctors&apos;&#xa0;<span style="font-size: 0.95rem;">behalf, so watch their updates for changes in scope or deadlines.</span></div><div><br></div><div>If you already use clinic software, steps 3 to 5 may be covered. ClinicNex AI, for example,&#xa0;<span style="font-size: 0.95rem;"><a href="/#features">issues a PKR invoice for every visit</a> and shows the day&apos;s totals in its reports. If you&apos;re still&#xa0;</span><span style="font-size: 0.95rem;">on a register, this is a good time to move your billing to a system, whatever the final rule&#xa0;</span><span style="font-size: 0.95rem;">says.</span></div><div><br></div><div>Get your clinic&apos;s billing ready, whatever FBR decides. ClinicNex AI gives every patient a&#xa0;<span style="font-size: 0.95rem;">proper PKR invoice, keeps your records organised and shows your daily totals in one&#xa0;</span><span style="font-size: 0.95rem;">place, from PKR 10,000 a month with unlimited doctors. </span><a href="https://clinicnexai.com/" target="_blank" rel="noopener noreferrer" style="font-size: 0.95rem;"></a><a href="https://clinicnexai.com/register" target="_blank" rel="noopener noreferrer">Start your 7-day free trial</a><span style="font-size: 0.95rem;"> or book&#xa0;</span><span style="font-size: 0.95rem;">a free demo.&#xa0;</span><span style="font-size: 0.95rem;"><a href="https://clinicnexai.com/blog/how-to-start-a-clinic-in-pakistan" target="_blank" rel="noopener noreferrer">Opening
a new clinic? See our 10-step guide</a></span></div><div>&#xa0;&#xa0;</div><div>About the author: Sohail Anwar writes about running clinics in Pakistan for ClinicNex AI.&#xa0;<span style="font-size: 0.95rem;">This article is general information, not tax or&#xa0;</span><span style="font-size: 0.95rem;">legal advice.</span></div>

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Articles by Sohail Anwar

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FBR POS for Clinics Explained: Who's Covered and What Doctors Should Do Now