> ## Documentation Index
> Fetch the complete documentation index at: https://docs.bilby.health/llms.txt
> Use this file to discover all available pages before exploring further.

# Write a clinical note

> Start a note, use templates and placeholders, and add formatting, tables and images.

Notes live on the patient's **Notes** tab. A note starts as a draft. Once you publish it, it's part of the clinical record and can't be deleted.

## Start a note

1. Open the patient's **Notes** tab and select **New note**. Admins and reception choose which practitioner it's for.
2. Give it a title, choose whether it's a note, letter or report, and write.

To write a note for an appointment, open the appointment and select **Notes**.

Under the title you can link the note to an appointment and a referrer. The referrer is who a clinical letter goes to by default.

To start from an existing note, select **Duplicate** in its **Note actions** menu.

## Use a template

Select **Templates** in the toolbar and choose one. If the note already has text, Bilby asks before replacing it. Admins add templates in [Settings › Templates](https://docs.bilby.health/clinical/note-templates.md).

## Add placeholders

Placeholders fill in details from the record, such as the patient's name or the referrer's practice. Type `/` or select **Insert placeholder**, then choose one. They're filled in when you publish.

## Tables and images

Select **Table** in the toolbar to add a table, and again to add or remove rows and columns.

Select **Insert image** to add a photo or screenshot, or paste or drag it into the note. Drag its corner to resize it.

Select **Write full screen** for more room.


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