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EXHIBIT 4
HCA
PAR VALUE $.01
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INCORPORATED UNDER THE LAWS This certificate is transferable in CLEVELAND, OH or in NEW YORK, NY SEE REVERSE FOR
OF THE STATE OF DELAWARE CERTAIN DEFINITIONS
CUSIP 404119 10 9
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Our Mission and Values
Above all else, we are committed to the care and improvement of human life. In
recognition of this commitment, we strive to deliver high quality, cost
effective healthcare in the communities we serve.
In pursuit of our mission, we believe the following value statements are
essential and timeless.
(Y) We recognize and affirm the unique and intrinsic worth of each
individual.
(Y) We treat all those we serve with compassion and kindness.
(Y) We act with absolute honesty, integrity and fairness in the way we
conduct our business and the way we live our lives.
(Y) We trust our colleagues as valuable members of our healthcare team and
pledge to treat one another with loyalty, respect and dignity.
FULLY PAID AND NON-ASSESSABLE SHARES OF COMMON STOCK OF
HCA - The Healthcare Company transferable on the books of the Corporation by the
holder hereof in person or by duly authorized attorney upon surrender of this
certificate properly endorsed. This certificate and the shares represented
hereby are issued under and are subject to all the provisions of the Certificate
of Incorporation and By-Laws of the Corporation and all amendments thereto,
copies of which are on file with the Transfer Agent, to all of which the holder
of this certificate assents by acceptance hereof. This certificate is not valid
unless countersigned by the Transfer Agent and registered by the Registrar.
Witness the facsimile seal of the Corporation and the facsimile
signatures of its duly authorized officers.
Dated:
Countersigned and Registered:
NATIONAL CITY BANK
(CLEVELAND, OHIO)
Transfer Agent
and Registrar
BY
Authorized Signature
CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER
VICE PRESIDENT, LEGAL AND CORPORATE SECRETARY
THOMAS F. FRIST, SR., M.D.
HCA - The Healthcare Company
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THE CORPORATION WILL FURNISH WITHOUT CHARGE TO EACH STOCKHOLDER WHO SO
REQUESTS A STATEMENT OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE,
PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OR SERIES
THEREOF, WHICH THE CORPORATION IS AUTHORIZED TO ISSUE, AND THE QUALIFICATIONS,
LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND/OR RIGHTS.
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TEN COM -- as tenants in common UNIF GIFT MIN ACT -- _________ Custodian _________
TEN ENT -- as tenants by the entireties (Cust) (Minor)
JT TEN -- as joint tenants with right under Uniform Gifts to Minors
of survivorship and not as Act _________________
tenants in common (State)
UNIF TRAN MIN ACT -- _________ Custodian __________
(Cust) (Minor)
under Uniform Transfers to Minors
Act _________________
(State)
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Additional abbreviations may also be used though not in the above list
For value received, _________ hereby sell, assign and transfer unto
PLEASE INSERT SOCIAL SECURITY OR OTHER
IDENTIFYING NUMBER OF ASSIGNEE
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________________________________________________________________________________
________________________________________________________________________________
_________________________________________________________________________ Shares
of the capital stock represented by the within Certificate, and do hereby
irrevocably constitute and appoint_____________________________ Attorney to
transfer the said stock on the books of the within - named Corporation with full
power of substitution in the premises.
Dated, ___________
X
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NOTICE: THE SIGNATURE TO THIS ASSIGNMENT MUST
CORRESPOND WITH THE NAME AS WRITTEN UPON THE
FACE OF THE CERTIFICATE IN EVERY PARTICULAR,
WITHOUT ALTERATION OR ENLARGEMENT, OR ANY
CHANGE WHATEVER.
SIGNATURE(S) GUARANTEED:
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THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN
ELIGIBLE GUARANTOR INSTITUTION, (BANKS,
STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS
AND CREDIT UNIONS WITH MEMBERSHIP IN AN
APPROVED SIGNATURE GUARANTEE MEDALLION
PROGRAM), PURSUANT TO S.E.C. RULE 17 Ad-15.
KEEP THIS CERTIFICATE IN A SAFE PLACE. IF IT IS LOST, STOLEN, MUTILATED OR
DESTROYED, THE CORPORATION WILL REQUIRE A BOND OF INDEMNITY AS A CONDITION TO
THE ISSUANCE OF A REPLACEMENT CERTIFICATE.
