Paper register, Excel or clinic software: what should a small clinic use?

Prices are in rupees and change often, so treat them as a rough guide. The links are at the bottom of the page.

If you are just opening, see a handful of patients a day, rarely need an old file and do all the paperwork yourself, a register works. It needs no power, no internet and no training.

If you stay on paper, use a pre-printed format for notes and prescriptions. In a Peshawar study, prescriptions with no legibility problems went from 76% to 94% once doctors used a printed form, which is a big gain for almost no cost.

If you are comfortable with spreadsheets, work alone, and mostly need a list of names, numbers and fees, Excel or Google Sheets will do. Google Sheets is free with a Google account, and the Excel app is free for basic editing on phones and small tablets.

The trouble starts when a sheet has to hold visits. One row per patient doesn't fit a patient who comes eleven times; one row per visit makes the history hard to read. Formulas get broken, copies end up on WhatsApp, and there is no record of who changed what.

Software earns its place when you have repeat patients with follow-ups and instalments, more than one doctor or a receptionist, appointments to remind people about, prescriptions to send, or registers to keep for the healthcare commission.

The real cost of paper is time and missed information. In a large study of primary care clinics, information was missing in 13.6% of visits, and doctors felt that in more than half of those cases it could delay care. Clinicians with complete electronic records were much less likely to be missing it.

It matters more in some cities than others. In NEPRA's latest yearly report, distribution companies reported average daily load-shedding of about 10 hours in QESCO's area, 8 in HESCO's, 5.5 in PESCO's and about 5 in K-Electric's, while Lahore, Islamabad, Faisalabad and Gujranwala reported very little.

Paper doesn't care. Excel on a laptop with a charged battery is fine too. FindClinica keeps working on the phone with no internet and syncs later; the one thing it can't do offline is send a prescription, because the prescription image is made on our server.

Pakistan's Personal Data Protection Bill still hadn't become law in 2026, so there is no specific rule today about where patient records may be kept. The practical risks are the same either way: a register anyone can read, a laptop without a password, a sheet forwarded to the wrong WhatsApp group.

Software doesn't make those risks disappear, but it does put the records behind one account with a known list of devices.

Don't copy the old registers in. Start new patients in the app from a Monday, add old ones when they come back, and keep the registers on the shelf. There is no import from Excel yet, so the same goes for a spreadsheet. How the patient record app works.