[Hospital Name]

[HospitalAddress]
Patient Vital Signs Record(Anaesthetic Machine)
  Registration Date : [RegDate]
Patient ID [PatientID] Patient Name [PatientName]
Address [Address1] DOB [DOB]
[Address2]    
Gender / Age [Sex] / [Age]    
Home [Home] Mobile [Mobile]
Email [Email] Doctor Name Dr.  [DoctorName] [DocQualification] , [Speciality]