Kenneth Aitken, 66, died of a suspected heart attack in March after being sent home in his pyjamas from accident and emergency with a packet of paracetamol.
His devastated widow, Wendy, has now been sent a bill for £25.30 by NHS Fife to cover the taxi fare.
The demand to the dead OAP even gave him the option to “pay in person”.
Mrs Aitken, from Dunfermline, branded the letter “dreadful” and “very upsetting”.
The letter was addressed directly to Mr Aitken. It was written by Barrie Higgins, facilities manager at Victoria Hospital, Kirkcaldy, and headed “recharge of taxis”.
It states: “On the 14.03.14, a hospital taxi was arranged to enable you to return home after attending the accident & emergency department of the Victoria Hospital, as you’d had no funds with you.
“The cost of the taxi was £25.30. This was made as a loan and I would be grateful if you could arrange to make the repayment at your earliest convenience.”
Mrs Aitken said: “It’s dreadful, very upsetting. The letter is the only contact I have had.
“The letter arrived last week and I phoned the hospital right away but all I got was an answer machine.”
She added: “It was dreadful the way my husband died. That should never have happened and then to get this letter addressed to him is unbelievable.
“I am still waiting for answers on why he was sent home in the first place. He had a heart attack two years before, which left him with heart failure. He had a stroke 20 years ago which left him blind. He was also epileptic and diabetic, and they sent him home at four in the morning.
“Graeme was a Lib Dem councillor for 12 years, serving the community and this is how he is treated.”
Mr Aitken was found by his wife at around 4:30am clinging to their garden hedge, shouting: “Wendy, help me! Please help me!” She had to call an ambulance to take him back to the hospital.
After receiving the letter, Mrs Aitken complained to NHS Fife and received a response for the health board’s director of acute services, Heather Knox.
NHS Fife said in a statement: “We deeply regret the anxiety caused by the receipt of a letter from our hospital requesting the cost of the taxi journey.
“This was the result of a clerical error. It is terrible that this has happened and we have written to Mrs Aitken offering our most sincere apologies.
“We have taken immediate action to ensure that this cannot happen again.”
Margaret Watt, of the Scottish Patients Association, yesterday criticised the blunder. She said: “It is absolutely horrendous what happened to that man – that bill should not have been sent to him. He should not have been discharged in the middle of the night. What kind of country are we when we are treating patients like this?”