diff --git a/Care/Operations/patient_medication_return_pallium.md b/Care/Operations/patient_medication_return_pallium.md
new file mode 100644
index 0000000..3babfab
--- /dev/null
+++ b/Care/Operations/patient_medication_return_pallium.md
@@ -0,0 +1,64 @@
+
+# Patient Medication Return
+
+> Line-level list of medication returns from patients with batch, destination, invoice, and staff details
+
+## Purpose
+
+Lists completed medication returns at Pallium where stock has been delivered **back from a patient** into a facility location. Each row shows the medication, patient (with MRN), quantity returned, destination location, originating invoice, return date, and the user who recorded the return.
+
+## Parameters
+
+| Parameter | Type | Description | Example |
+|-----------|------|-------------|---------|
+| `date` | DATE / range | Metabase date filter (typically bound to `sd.created_date`) | `'2026-06-01'` |
+
+---
+
+## Query
+
+```sql
+SELECT
+    pk.name AS medication_name,
+    p_patient.name AS patient_name,
+    pi.value AS mrn,
+    sd.supplied_item_quantity AS quantity_returned,
+    fl.name AS returned_to_destination,
+    inv.number AS invoice_number,
+    sd.created_date AS return_date,
+    TRIM(created_user.first_name || ' ' || created_user.last_name, '') AS created_by
+FROM emr_supplydelivery sd
+JOIN emr_deliveryorder dorder
+    ON sd.order_id = dorder.id
+JOIN emr_patient p_patient
+    ON dorder.patient_id = p_patient.id
+LEFT JOIN emr_patientidentifier pi
+    ON p_patient.id = pi.patient_id
+   AND pi.config_id = 4
+JOIN emr_invoice inv
+    ON dorder.patient_invoice_id = inv.id
+JOIN emr_facilitylocation fl
+    ON dorder.destination_id = fl.id
+JOIN emr_inventoryitem ii
+    ON sd.supplied_inventory_item_id = ii.id
+JOIN emr_product p
+    ON ii.product_id = p.id
+JOIN emr_productknowledge pk
+    ON p.product_knowledge_id = pk.id
+LEFT JOIN users_user created_user
+    ON sd.created_by_id = created_user.id
+WHERE dorder.patient_id IS NOT NULL
+  AND dorder.supplier_id IS NULL
+  AND sd.status = 'completed'
+  --[[AND {{date}}]]
+ORDER BY sd.created_date DESC;
+```
+
+## Notes
+
+- **Return semantics:** A delivery is treated as a *patient return* when the `emr_deliveryorder` has a `patient_id` set **and** no `supplier_id` — i.e. the stock is flowing back from the patient into a facility location rather than from a supplier.
+- **Destination:** `dorder.destination_id` joined to `emr_facilitylocation` shows the inventory location the medication was returned to.
+- **Metabase filter:** `[[AND {{date}}]]` is a field filter — bind it to `sd.created_date` in the Metabase variable settings.
+- Results are ordered by most recent `return_date` first.
+
+*Last updated: 2026-06-29*