Kayla Ellis

 
 BAYLOR SCOTT & WHITE 
 Williams, Charles Eugene 
 BaylorScott&White 
 HEART AND VASCULAR 
 MRN: 9211614, D.O.B: 25/97/10, Sex: M 
 HEALTH 
 HOSPITAL - DALLAS 
 Date Service 29/16/05
 621 N HALL ST 
 DALLAS TX 75226-1339 
 02/09/2023 - Telephone in Baylor Scott & White Heart and Vascular Hospital - Dallas (continued) 
 Clinical Notes (continued) 
 Patient s/p: EPS ablation 

 Pt denies other questions, comments or concerns at this time. 
 Electronically signed by Rachel Galvan To. RN at 27/21/05 10:17 PM 
 02/09/2023 - Telephone in Baylor Scott & White Heart and Vascular Hospital - Dallas 
 Facesheet 
 Patient Information 
 Patient Name 
 Legal Sex 
 DOB 
 Williams, Charles Eugene
 Male 
 2/4/1959 
 Patient Demographics 
 Address 
 Phone 
 E-mail Address 
 6563 ASHLAND DR 
 963-263-7630 (Home) *Preferred* 
 lorinewilliams63@yahoo.com 
 GREENVILLE TX 75463-7628 
 963-263-88637 (Work) 
 63-631-6388 (Mobile) 
 Basic Information 
 Date Of Birth 
 Legal Sex 
 Race 
 Ethnic Group 
 Preferred Language 
 Language for Written 
 15/19/12
 Male 
 Black or African 
 English 
 Material 
 American 
 Latino 
 English 
 Page 2 
 75208-63 
 Baylor Scott & White Heart & Vascular Hospital - 00063
