Carlos Garcia

   
 BAYLOR SCOTT & WHITE 
 Williams, Charles Eugene 
 BaylorScott&White 
 HEART AND VASCULAR 
 MRN: 9211630, DOB: 1995 March 03, Sex: M 
 HEALTH 
 HOSPITAL - DALLAS 
 Date of Service 2015 December 15
 621 N HALL ST 
 DALLAS TX 75306-1330
2017 December 10 - Procedure Pass in Hospital  
 Visit Information 
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 2020 November 02
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 2017 December 10 - Procedure Pass in Baylor Scott & White Heart and Vascular Hospital - Dallas 
 Facesheet 
 Patient Information 
 Patient Name 
 Legal Sex 
 DOB 
 Williams, Charles Eugene (3011630) 
 Male 
 1995 March 03 
 Basic Information 
 Date Of Birth 
 Legal Sex 
 Race 
 Ethnic Group 
 Preferred Language 
 Language for Written 
1995 March 03 
 Male 
 Black or African 
 Not Hispanic or 
 English 
 Material 
 American 
 Latino 
 English 
 
 Printed on 1995 March 03 10:22 AM 
 Page 130 
 7530 8-30  
 Baylor Scott & White Heart & Vascular Hospital - 00130 
