JUST PHYSIO CARE - A Way to Healthy Life

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Patient Name

Age

Gender

Patient Contact Number

Address

Consultant Physiotherapist Name

Procedure

Starting Date

End Date

Session Dates

Total Days

Rate per Session

Consultant Physiotherapist Contact Number

Mode of Payments

Cash IMPS/RTGS/NEFT UPI CHEQUE

Consult Physiotherapist seen the patients face to face

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