PUTNAM TAX FREE HEALTH CARE FUND
N-30D, 1994-08-08
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<PAGE>
 
                                         Putnam
                                         Tax-Free
                                         Health Care
                                         Fund



ANNUAL REPORT
May 31, 1994



                         [LOGO OF PUTNAM APPEARS HERE]
<PAGE>
 
PERFORMANCE HIGHLIGHTS

Putnam Tax-Free Health Care Fund significantly outperformed the average 
general closed-end municipal bond fund tracked by Lipper for the one-year 
period ended May 31, 1994.  The fund's total return at net asset value of 
5.08% was well ahead of the 1.59% category average over this period.

Performance should always be considered in light of a fund's investment 
strategy. Putnam Tax-Free Health Care Fund is designed for investors seeking 
high current income free from federal income tax and consistent with 
preservation of capital through a portfolio of securities in the health care 
sector.

FISCAL 1994 RESULTS AT A GLANCE

<TABLE> 
<CAPTION> 
                                                                                   
                                                                            MARKET
TOTAL RETURN:                                        NAV                     PRICE
<S>                                              <C>                    <C> 
Twelve months ended 5/31/94
(change in value during period 
plus reinvested earnings)                            5.08%                   6.46%
                                                                              
                                                                            MARKET
SHARE VALUE:                                         NAV                     PRICE

5/31/93                                            $14.73                  $14.625
5/31/94                                             14.29                   14.375
DISTRIBUTIONS:                                      CAPITAL GAINS/1/
                          NUMBER         INCOME                              TOTAL
                            12           $1.0128   $0.185                  $1.1978

                                                                           MARKET
CURRENT RETURN                                       NAV                    PRICE

(end of period)
Current divided rate/2/                              7.09%                  7.05%
Taxable equivalent/3/                               11.74                   11.67
</TABLE> 

Performance data represent past results. For performance over longer periods,
see pages 8 and 9. /1/Capital gains are taxable. Investment income may be
subject to state and local taxes. /2/Income portion of most recent distribution,
annualized and divided by NAV or market price at end of period. /3/Assumes
maximum 39.6% federal tax rate. Results for investors subject to lower tax rates
would not be as advantageous. The fund will not invest in securities subject to
the federal Alternative Minimum Tax for individual investors.

2
<PAGE>
 
                                              [PHOTOGRAPH APPEARS HERE]
                                                  (C)Karsh, Ottawa

FROM THE CHAIRMAN


DEAR SHAREHOLDER:

THE FEDERAL RESERVE BOARD'S PRIMARY CONCERN REMAINS FIGHTING NOT ONLY 
INFLATION BUT THE FEAR OF INFLATION. IT IS ADDRESSING THIS ISSUE BY GRADUALLY 
RAISING THE SHORT-TERM INTEREST RATES UNDER ITS CONTROL TO SLOW THE ECONOMY'S 
GROWTH TO WHAT IT REGARDS AS A SUSTAINABLE PACE. 

THE COMBINATION OF THE FED'S CONTINUING POLICY AND THE RESPONSE BY 
INDIVIDUALS AND BUSINESSES TO LAST YEAR'S TAX INCREASE COULD PRODUCE MORE OF 
A SLOWDOWN IN BUSINESS THAN MANY OBSERVERS NOW EXPECT. 

AS THIS SLOWING BECOMES MORE OBVIOUS, THE FED WILL COME UNDER GROWING 
PRESSURE FROM POLITICIANS TO EASE UP. THE FED IS NOT LIKELY TO YIELD. BUT THE 
VERY FACT THAT INVESTORS THINK IT MIGHT COULD CAUSE SOME MORE VOLATILITY IN 
THE BOND MARKETS IN THE MONTHS AHEAD. 

MEANWHILE, YOU CAN TAKE COMFORT IN THE TAX SHELTER PROVIDED FOR THE INCOME 
GENERATED BY YOUR PUTNAM TAX-EXEMPT FUND SHARES. 

IN THE FOLLOWING REPORT, FUND MANAGER HOWARD MANNING EXPLAINS HOW HE IS 
POSITIONING  YOUR FUND'S PORTFOLIO TO RESPOND TO 1994'S UNFOLDING EVENTS.

RESPECTFULLY YOURS,

GEORGE PUTNAM
JULY 20, 1994

3
<PAGE>
 
REPORT FROM THE FUND MANAGER
HOWARD K. MANNING


Putnam Tax-Free Health Care Fund's fiscal year ended May 31, 1994, was marked 
by significant changes in the investment climate.  During the past 12 months, 
a sluggish economic recovery gathered enough steam to fuel concerns that 
higher inflation might be looming on the horizon. This period saw interest 
rates fall to their lowest levels in decades, causing bond prices to increase 
dramatically. And this year, the Federal Reserve Board, after establishing an 
expansionary monetary policy for several years, adopted a more restrictive 
stance by raising short-term interest rates. Shortly before the end of the 
fiscal year, these rate increases sparked a sell-off in the bond market, 
causing prices to decline sharply.  

Despite the market volatility, your fund produced a total return of 5.08% at 
net asset value for the fiscal year, significantly ahead of the 2.47% return 
for municipal bonds in general, as measured by the Lehman Brothers Municipal 
Bond Index. The fund's 7.09% current dividend rate at net asset value would 
have been the equivalent of an 11.74% current return on fully taxable 
investments for investors in the maximum 39.6% federal income tax bracket.

While the subject of health care reform dominated the headlines during the 
fiscal year, it had no direct impact on how we managed the portfolio. As we 
analyzed the health care market, we continued to see reform taking place 
throughout the country where hospital consolidations and managed care 
programs are significantly reducing inefficiencies in the current system.  

PURSUING OPPORTUNITY IN A VOLATILE MARKET

While we maintained the fund's investment strategy of capitalizing on 
opportunities and efficiencies in the health care market, we also 

4
<PAGE>
 
took measures to protect the fund from market volatility -- shortening the 
average duration of the fund's fixed-income holdings, for example. Duration 
measures a bond fund's sensitivity to interest rate movements. Since bond 
prices fall when interest rates rise, any reduction in the fund's sensitivity 
to such forces helps protect the value of the fund's assets. 

STRICT CREDIT ANALYSIS DRIVES OUR DECISIONS

In-depth research and analysis continued to be the driving force behind our
investment decisions. Our approach is to analyze the health care environment in
key states such as California, Minnesota, Florida, and Michigan, select the
markets that hold the most promise within those states, and then scrutinize the
credit quality, funding sources, and prospects of a broad selection of bonds
before choosing the best prospects for investment.

This type of rigorous credit analysis has led to a number of attractive 
additions to the portfolio over the period. Our research efforts in the 
Chicago market brought Grant Hospital to our attention. When the hospital was 
acquired by Columbia Health Care System, the nation's largest hospital 
management company, Grant's bonds were prerefunded. Prerefunding occurs when 
an issuer raises money to pay off a specific bond in advance and invests that 
money in a secure investment, such as a Treasury bill, that matures at the 

                            [ARTWORK APPEARS HERE]

                       CHART WITH CONCENTRATION BY STATE

<TABLE> 
<S>                          <C> 
CALIFORNIA                   12.3%
PENNSYLVANIA                 11.8
MASSACHUSETTS                10.1
TEXAS                         9.8
ARIZONA                       7.8
</TABLE> 


5
<PAGE>
 
bond's maturity date. This added security is often perceived as a credit 
upgrade by the market and can boost the bond's price. Following the 
prerefunding, we were able to sell the bonds at a substantial profit.

Our credit analysis also led to the acquisition of bonds of the Friendly 
Hills Health Care Network (FHHN) in La Habra, California. FHHN is an 
integrated health care delivery system. This type of health care delivery 
system combines a health maintenance organization (HMO), hospital, and other 
medical facilities under one umbrella organization. FHHN is the first 
organization to be established under a recent IRS ruling that allows 
physician groups to develop comprehensive delivery systems, and the FHHN bond 
issue is the first tax-exempt bond issue of its kind. FHHN has attracted the 
attention of many health care policymakers, including Hillary Clinton. We 
believe that the integrated health care system approach represents the 
cutting edge of health care delivery in this country.

FOCUS ON HOSPITAL BONDS

At the end of the period, 94% of the fund's holdings were not-for-profit
hospital bonds. The rest of the portfolio was invested in HMOs, integrated
health care delivery systems, and nursing homes. Because most hospital
securities generally carry BBB ratings, about half of the securities in the
portfolio were in this rating category. The rest of the bonds were nearly evenly
divided among AAA-rated prerefunded bonds and BB-and B-rated bonds, for an
average quality rating of BBB at the end of the period.

LOOKING AHEAD

In general, we believe the economy will slow down from the pace set in the early
part of the year, and inflation will remain at a moderate level. While the Fed
may raise rates again in ongoing efforts to keep inflation in check, we believe
rates will stay relatively low by historic standards.

6
<PAGE>
 
TOP 10 HOLDINGS (5/31/94)

MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES 
AUTHORITY

MICHIGAN HOSPITAL FINANCING REVENUE BONDS

SIERRA VISTA, ARIZONA, INDUSTRIAL DEVELOPMENT AUTHORITY HOSPITAL REVENUE 
BONDS

NEW YORK STATE MEDICAL CARE FACILITIES FINANCING AGENCY REVENUE BONDS

TULSA, OKLAHOMA, INDUSTRIAL AUTHORITY HOSPITAL REVENUE BONDS

CALIFORNIA HEALTH FACILITIES AUTHORITY REVENUE BONDS

KANSAS CITY, MISSOURI, INDUSTRIAL DEVELOPMENT AUTHORITY HEALTH FACILITIES 
REVENUE BONDS

ALLEGHENY COUNTY, PENNSYLVANIA, HOSPITAL DEVELOPMENT AUTHORITY REVENUE BONDS

BEXAR COUNTY, TEXAS, HEALTH FACILITIES DEVELOPMENT CORP. REVENUE BONDS

ORANGE COUNTY, FLORIDA, HEALTH FACILITIES AUTHORITY REVENUE BONDS

These holdings represent 34.8% of the fund's net assets. Portfolio holdings 
are subject to change.

Many health care organizations are already in the process of restructuring 
the way they deliver health care, and we believe this trend toward reform 
will present many attractive investment opportunities in the future. We will 
continue to monitor health care reform efforts at both the state and federal 
level. Painstaking research will continue to be a major ingredient in our 
decision-making process as we seek new investments for the fund.

7
<PAGE>
 
PERFORMANCE SUMMARY

This section provides, at a glance, information about your fund's 
performance. Total return shows how the value of the fund's shares changed 
over time, assuming you held the shares through the entire period and 
reinvested all distributions back into the fund. We show total return in two 
ways: On a cumulative long-term basis  and how the fund might have grown each 
year, on average, over varying periods. For comparative purposes, we show how 
the fund performed relative to appropriate indexes and benchmarks.

TOTAL RETURN FOR PERIODS ENDING 5/31/94

<TABLE> 
<CAPTION> 
                                                    Lehman Brothers    Consumer
                                          Market      Muni Bond         Price
                           NAV            price          Index          Index
- -------------------------------------------------------------------------------
<S>                       <C>            <C>            <C>            <C> 
1 year                     5.08%          6.46%          2.47%          2.29%
- -------------------------------------------------------------------------------
Life of fund*             18.58          10.46          12.84           5.21
Annual average             9.28           5.32           6.49           2.68
- -------------------------------------------------------------------------------
</TABLE> 


TOTAL RETURN FOR PERIODS ENDING 6/30/94
(most recent calendar quarter)

<TABLE> 
<CAPTION>
                                                                        Market
                                                          NAV            price
- -------------------------------------------------------------------------------
<S>                                                      <C>            <C> 
1 year                                                    3.21%          4.99%
- -------------------------------------------------------------------------------
Life of fund*                                            18.16          11.42
Annual average                                            8.70           5.56
- -------------------------------------------------------------------------------
</TABLE> 

* The fund began investment operations on 6/29/92. Performance data represent 
  past results. Investment returns and net asset value will fluctuate so an
  investor's shares, when sold, may be worth more or less than their original
  cost.

  NET ASSET VALUE (NAV) is the value of all fund assets, minus liabilities,
  divided by the number of outstanding shares.

  MARKET PRICE is the current trading price of one share of the fund. Market
  prices are set by transactions between buyers and sellers on the New York
  Stock Exchange.

  LEHMAN BROTHERS MUNICIPAL BOND INDEX is an unmanaged list of long-term fixed-
  rate investment-grade tax-exempt bonds representative of the municipal bond
  market. The index does not take into account brokerage commissions or other
  costs, may include bonds different from those in the fund, and may pose
  different risks than the fund.

  CONSUMER PRICE INDEX is a commonly used measure of inflation. It does not
  represent an investment return.

8
<PAGE>
 
Report of independent accountants
for the year ended May 31, 1994

To the Trustees and Shareholders of Putnam Tax-Free Health Care Fund

In our opinion, the accompanying statement of assets and liabilities, 
including the portfolio of investments owned (except for bond ratings), and 
the related statements of operations and of changes in net assets and the 
financial highlights present fairly, in all material respects, the financial 
position of Putnam Tax-Free Health Care Fund (the "fund") at May 31, 1994, 
and the results of its operations, the changes in its net assets and the 
financial highlights for the periods indicated, in conformity with generally 
accepted accounting principles.  These financial statements and financial 
highlights (hereafter referred to as "financial statements") are the 
responsibility of the fund's management; our responsibility is to express an 
opinion on these financial statements based on our audits.  We conducted our 
audits of these financial statements in accordance with generally accepted 
auditing standards, which require that we plan and perform the audit to 
obtain reasonable assurance about whether the financial statements are free 
of material misstatement.  An audit includes examining, on a test basis, 
evidence supporting the amounts and disclosures in the financial statements, 
assessing the accounting principles used and significant estimates made by 
management, and evaluating the overall financial statement presentation.  We 
believe that our audits, which included confirmation of investments owned at 
May 31, 1994 by correspondence with the custodian and brokers and the 
application of alternative auditing procedures where confirmations from 
brokers were not received, provide a reasonable basis for the opinion 
expressed above.

Price Waterhouse LLP
Boston, Massachusetts
July 18, 1994

9
<PAGE>
 
PORTFOLIO OF INVESTMENTS OWNED 
May 31, 1994

<TABLE> 
<CAPTION> 
MUNICIPAL BONDS AND NOTES(97.4%)(a)
PRINCIPAL AMOUNT                                                                       RATINGS(b)          VALUE
ARIZONA(7.8%)
- ----------------------------------------------------------------------------------------------------------------------
<S>                                                                                    <C>              <C> 
$ 4,000,000    Payson, Indl. Dev. Auth. Hosp. Rev. Bonds
               (Payson Regl. Med. Ctr. Inc. Project), 7.7s, 10/1/23                        B/P          $    3,800,000
  4,285,000    Pinal Cnty., Indl. Dev. Auth. Rev. Bonds
               (Casa Grande Regl. Med. Ctr.), 9s, 12/1/13                                  BB/P              4,493,894
  6,480,000    Sierra Vista, Indl. Dev. Auth. Hosp. Rev. Bonds
               (Sierra Vista Cmnty. Hosp. Project), 8 1/2s, 12/1/21                        BBB/P             7,030,800
                                                                                                          ------------
                                                                                                            15,324,694
CALIFORNIA(12.3%)
- ----------------------------------------------------------------------------------------------------------------------
  4,000,000    Berkeley, Hlth. Facs. Rev. Bonds
               (Alta Bates Med. Ctr.), Ser. A, 6.55s, 12/1/22                              Baa               3,685,000
               CA Hlth. Facs. Auth. Rev. Bonds (Summit Med. Ctr.),
  3,195,000    Ser. 85A, 9s, 5/1/15                                                        Ba                3,294,844
  2,215,000    Ser. A, 7 1/2s, 5/1/09                                                      Ba                2,170,700
  2,590,000    CA Hlth. Facs. Fin. Auth. Variable Rate Demand Notes
               (VRDN)(St. Joseph Hlth. Syst.), Ser. A. 3.1s, 7/1/13                        VMIG1             2,590,000
  2,000,000    CA Statewide Cmntys. Dev. Auth. Certif. of Participation 
               (Childrens Hosp.), Municipal Bond Insurance Assn.
               (MBIA), 6s, 6/1/12                                                          AAA               1,987,500
  4,000,000    La Habra, Certif. of Participation     
               (Friendly Hills Hlth. Care Foundation), Ser. A, 7.15s, 7/1/23               BB/P              3,930,000
  2,200,000    Rancho Mirage, Joint Pwr. Fin. Auth. Certif. of
               Participation
               (Eisenhower Memorial Hosp.), 7s, 3/1/22                                     A                 2,241,250
  2,560,000    San Bernardino Hosp. Rev. Bonds
               (San Bernardino, Cmnty. Hosp.), 7 7/8s, 12/1/08                             Ba                2,582,400
  2,000,000    Valley Hlth. Syst. Certif. of Participation
               6 7/8s, 5/15/23                                                             BB                1,867,500
                                                                                                           -----------
                                                                                                            24,349,194
CONNECTICUT(0.6%)
- ----------------------------------------------------------------------------------------------------------------------
  1,200,000    CT Dev. Auth. Hlth. Care Rev. Bonds (AHF/Windsor Inc. Project),
               Ser. A, 9 1/2s, 1/1/22                                                      B/P               1,242,000

FLORIDA(5.8%)
- ----------------------------------------------------------------------------------------------------------------------
  2,500,000    Cape Coral, Hlth. Fac. Auth. Hosp. Rev. Bonds
               (Cape Coral Med. Ctr. Inc. Project), 7 1/2s, 11/15/21                       Baa               2,587,500
  2,000,000    Miami, Hlth. Facs. Auth. Rev. Bonds
               (Cedars Med. Ctr.), Ser. A, 8 3/8s, 10/1/17                                 AAA/P             2,250,000
  2,000,000    Orange Cnty., Hlth. Fac. Auth. 1st Mtge. Rev. Bonds
               (Princeton Hosp.), 9s, 7/1/21                                               BA/P              2,120,000
  2,600,000    Orange Cnty., Hlth. Fac. Auth. Residual Interest Bonds (RIBS),
               Ser. 91-C, MBIA, 9.533s, 10/29/21                                           AAA               2,626,000
  1,610,000    Palm Beach Cnty., Hlth. Fac. Auth. Rev. Bonds
               (JFK Med. Ctr. Inc. Project), 8 7/8s, 12/1/18                               AAA               1,787,100
                                                                                                           -----------
                                                                                                            11,370,600
ILLINOIS(3.6%)
- ----------------------------------------------------------------------------------------------------------------------
              IL Dev. Fin. Auth. Rev. Bonds (Cmnty. Rehab. Providers Fac.),
  2,410,000   8 3/4s, 7/1/11                                                               BBB/P             2,434,100
    915,000   8 3/4s, 3/1/10                                                               BBB/P               936,731
</TABLE> 

10
<PAGE>
 
<TABLE> 
<CAPTION> 
MUNICIPAL BONDS AND NOTES
PRINCIPAL AMOUNT                                                                       RATINGS(b)          VALUE

ILLINOIS(continued)
- ----------------------------------------------------------------------------------------------------------------------
<S>                                                                                    <C>              <C> 
              IL Hlth. Fac. Auth. Rev. Bonds 
$ 2,750,000   (St. Elizabeth's Hosp.), 10 1/8s, 7/1/16                                     B/P            $  2,777,500
  1,050,000   (Proctor Cmnty. Hosp. Project), 7 3/8s, 1/1/23                               Baa               1,021,125
                                                                                                           -----------
                                                                                                             7,169,456
KENTUCKY(1.9%)
- ----------------------------------------------------------------------------------------------------------------------
  2,000,000   Jefferson Cnty., Hosp. RIBS
              (Alliant Hlth. Syst. Project), MBIA, 9.648s, 10/23/14                        AAA               2,107,500
  1,570,000   Muhlenberg Cnty., Hosp. Rev. Bonds
              (Muhlenberg Cmnty. Hosp. Project), 9 1/2s, 8/1/10                            BB/P              1,719,150
                                                                                                           -----------
                                                                                                             3,826,650
MARYLAND(2.4%)
- ----------------------------------------------------------------------------------------------------------------------
  2,935,000   Berlin, Hosp. Rev. Bonds
              (Atlantic Gen. Hosp. Fac.), 8 3/8s, 6/1/22                                   BB/P              3,078,081
  2,100,000   MD State Hlth. & Higher Edl. Fac. Auth. Rev. Bonds
              (Doctors Cmnty. Hosp.), 5 s, 7/1/24                                          Baa               1,724,625
                                                                                                           -----------
                                                                                                             4,802,706
MASSACHUSETTS(10.1%)
- ----------------------------------------------------------------------------------------------------------------------
  3,950,000   Boston, Rev. Rfdg. Bonds Ser. B,
              (City Hospital), 5 3/4s, 2/15/23                                             AAA               3,648,813
              MA Hlth. & Edl. Fac. Auth. Rev. Bonds,
  2,235,000   (St. Joseph's Hosp.), Ser. C, 9 1/2s, 10/1/20                                AAA               2,718,319
  3,300,000   (Waltham-Weston Hosp. & Med. Ctr.), Ser. B, 8 3/8s, 7/1/15                   Baa               3,539,250
  3,000,000   (Norwood Hosp.), Ser. E, 8s, 7/1/12                                          Baa               3,071,250
  3,000,000   (Cooley Dickinson Hosp.), Ser. A, 7 1/8s, 11/15/18                           BB/P              3,067,500
              MA Indl. Fin. Agcy. Rev. Bonds
  1,000,000   (Oddfellows Home), 9.6s, 1/1/15                                              BB/P              1,042,500
  2,445,000   (Morton Hosp. & Med. Ctr.), Ser. A, 8 3/4s, 7/1/11                           Aaa               2,882,044
                                                                                                           -----------
                                                                                                            19,969,676
MICHIGAN(7.8%)
- ----------------------------------------------------------------------------------------------------------------------
  1,980,000   Detroit, Hosp. Fac. Fin. Auth. Rev. Bonds
              (MI Hlth. Care Corp.), 10s, 12/1/20                                          B                 2,076,525
     55,000   Highland Park, Fin. Auth. Hosp. Fac. Rev. Bonds
              (MI Hlth. Care Corp. Project), Ser. A, 9 3/4s, 12/1/06                       B                    56,719
              MI Hosp. Fin. Auth. Rev. Bonds
  4,500,000   (Garden City Hosp.), 8 1/2s, 9/1/17                                          Baa               4,781,250
  5,530,000   (Port Huron Hosp.), Ser. A, 7 5/8s, 7/1/15                                   Baa               5,847,975
  1,000,000   (Detroit-Macomb Hosp. Corp.), Ser. A, 7.3s, 6/1/01                           B                   990,000
              Tawas City, Hosp. Fin. Auth. Rev. Bonds
  1,465,000   (St. Joseph's Hosp. Project), Ser. A, 8 1/2s, 3/15/12                        BB/P              1,554,731
                                                                                                           -----------
                                                                                                            15,307,200
MINNESOTA(2.2%)
- ----------------------------------------------------------------------------------------------------------------------
  2,000,000   Minneapolis-St. Paul, Hsg. & Redev. Auth. Hlth. Care
              Syst. Rev. Bonds (Group Hlth. Plan Inc. Project),
              6.9s, 10/15/22                                                               A                 2,075,000
  2,300,000   Rochester, Hlth. Care Fac. Rev. Bonds 
              (Olmsted Med. Group), 7 1/2s, 7/1/19                                         BB/P              2,236,750
                                                                                                           -----------
                                                                                                             4,311,750
MISSOURI(2.8%)
- ----------------------------------------------------------------------------------------------------------------------
  5,000,000   Kansas City, Indl. Dev. Auth. Hlth. Fac. Rev. Bonds
              (Park Lane Med. Ctr. Project), 8 3/4s, 1/1/15                                BBB/P             5,437,500
</TABLE> 

11
<PAGE>
 
<TABLE> 
<CAPTION> 
MUNICIPAL BONDS AND NOTES
PRINCIPAL AMOUNT                                                                       RATINGS(b)          VALUE

NEW HAMPSHIRE(1.0%)
- ----------------------------------------------------------------------------------------------------------------------
<S>                                                                                    <C>              <C> 
$ 1,965,000   NH Higher Edl. & Hlth. Facs Auth. Rev. Bonds
              (Alice Peck Day Memorial Hosp. Project),  
              9 3/8s, 11/1/20                                                              BBB/P           $ 2,026,406

NEW JERSEY(3.2%)
- ----------------------------------------------------------------------------------------------------------------------
  3,000,000   NJ Econ. Dev. Auth. Rev. Bonds
              (Ocean Nursing Pavilion), Ser. A, 7 3/8s, 12/1/25                            BB/P              2,872,500
  3,200,000   NJ Hlth. Care Fac. Fin. Auth. Rev. Bonds
              (St. Elizabeth Hosp.), Ser. 90B, 8 1/4s, 7/1/20                              Baa               3,420,000
                                                                                                           -----------
                                                                                                             6,292,500
NEW MEXICO(0.8%)
- ----------------------------------------------------------------------------------------------------------------------
  1,375,000   Grant Cnty., Hosp. Fac. Rev. Bonds
              (Gila Regl. Med. Ctr. Project), 10s, 2/1/12                                  BBB/P             1,493,594
NEW YORK(2.9%)
- ----------------------------------------------------------------------------------------------------------------------
              NY State Med. Care Fac. Fin. Agcy. Rev. Bonds  
              (Mental Hlth. Svcs. Fac.), Ser. B
  2,135,000   7 7/8s, 8/15/20                                                              Baa               2,385,863
  2,810,000   7 7/8s, 8/15/20                                                              AAA               3,277,163
                                                                                                           -----------
                                                                                                             5,663,026
OHIO(1.2%)
- ----------------------------------------------------------------------------------------------------------------------
              Holland, Indl. Dev. Mtge. Rev. Bonds   
  2,136,359   (Spring Meadow Extended Care Project),
              Federal Housing Authority (FHA) Insd., 11s, 4/15/13                          A/P               2,374,029
OKLAHOMA(2.8%)
- ----------------------------------------------------------------------------------------------------------------------
              Tulsa, Indl. Auth. Hosp. Rev. Bonds (Tulsa Regional Med. Ctr.)
  2,395,000   Ser. A, 7 5/8s, 6/1/17                                                       BBB               2,514,750
  3,000,000   7.2s, 6/1/17                                                                 BBB               3,075,000
                                                                                                           -----------
                                                                                                             5,589,750
PENNSYLVANIA(11.8%)
- ----------------------------------------------------------------------------------------------------------------------
              Allegheny Cnty., Hosp. Dev. Auth. Rev. Bonds
  1,000,000   (Divine Providence Hosp.), Ser. A, 8 3/4s, 1/1/14                            BBB               1,072,500
  3,000,000   (Divine Providence Hosp.), Ser. B, 8 3/4s, 1/1/14                            BBB               3,217,500
  1,000,000   (Southside Hosp.-Pittsburgh), Ser. A, 8 3/4s, 6/1/10                         BBB               1,050,000
  2,260,000   Chartiers Valley, Indl. & Coml. Dev. Auth. Rev. Bonds
              (Beverly Enterprises Project), 6 1/2s, 2/1/07                                BB/P              2,155,475
  3,685,000   College Township, Indl. Dev. Auth. 1st Mtge. Hlth.
              Facs. Rev. Bonds (Nittany Valley Rehab. Hosp. Project),
              7 5/8s, 11/1/07                                                              BBB/P             3,740,275
  1,800,000   Lebanon Cnty., Hosp. Auth. Rev. Bonds
              (Good Samaritan Hosp.), Ser. B, 8 1/4s, 11/1/18                              BBB               2,083,500
  2,000,000   Montgomery Cnty., Higher Edl. & Hlth. Auth. Hosp. Rev.
              Bonds (UTD Hosp. Project), Ser. B, 8 3/8s, 11/1/11                           Ba                2,092,500
  2,950,000   Philadelphia Hosp. & Higher Ed. Fac. Auth. Hosp. RIBS
              7.767s, 3/6/12                                                               AAA               2,400,563
  2,500,000   Washington Cnty., Hosp. Auth. Rev. Bonds
              (Canonsburg Gen. Hosp. Project), 7.35s, 6/1/13                               BB/P              2,353,125
  3,030,000   York Cnty., Indl. Dev. Auth. 1st Mtge. Hlth. Fac. Rev. Bonds
              (Rehabilitation Hosp. of York Project), 7  1/2s, 9/1/07                      BBB/P             3,056,513
                                                                                                           -----------
                                                                                                            23,221,951
</TABLE> 

12
<PAGE>
 
<TABLE> 
<CAPTION> 
MUNICIPAL BONDS AND NOTES
PRINCIPAL AMOUNT                                                                       RATINGS(b)          VALUE

TENNESSEE(0.7%)
- ----------------------------------------------------------------------------------------------------------------------
<S>                                                                                    <C>              <C> 
$ 1,313,596   Meigs Cnty., Hlth. Edl. & Hsg. Fac. Board Rev. Bonds
              (Meigs Cnty. Hlth. Ctr.), FHA Insd., 12s, 7/15/25                            A/P            $  1,438,384
TEXAS(9.8%)
- ----------------------------------------------------------------------------------------------------------------------
  1,000,000   Amarillo, Hlth. Fac. Hosp. Corp. RIBS
              (High Plains Baptist Hosp.), 9.672s, 1/3/22                                  AAA               1,020,000
  5,000,000   Bexar Cnty., Hlth. Fac. Dev. Corp. Rev. Bonds                                           
              (St. Lukes Lutheran Hosp. Project), 7.9s, 5/1/11                             Baa               5,318,750
  1,085,000   Cherokee Cnty., Hlth. Fac. Dev. Corp. Rev. Bonds                                        
              (Nancy Travis Memorial Hosp. Project), 10s, 5/15/13                          B/P               1,154,169
  3,000,000   Harris Cnty., Hlth. Fac. Dev. Corp. Rev. Bonds                                          
              (Memorial Hosp.), Ser. A. 6 5/8s, 6/1/24                                     A                 3,000,000
  1,680,000   Montgomery Cnty., Hlth. Fac. Dev. Corp. Rev. Bonds                                      
              (Woodlands Med. Ctr. Project), 8.85s, 8/15/14                                BB/P              1,816,500
  2,000,000   North Central TX Hlth. Fac. Dev. Corp. RIBS                                             
              (Baylor Hlth. Care Syst.), Ser. B, 8.42s, 5/15/08                            AA                2,125,000
  3,500,000   Northeast Hosp. Auth. Rev. Bonds                                                        
              (Northeast Med. Ctr. Hosp.), Ser. B, Financial                                          
              Guaranty Insurance Co. (FGIC), 7 1/4s, 7/1/22                                Baa               3,482,500
  1,415,000   Tarrant Cnty., Hlth. Facs. Dev. Corp. Hosp. Rev. Bonds                                  
              (Cmnty. Hlth. Care Foundation Inc. Project), 10 1/8s, 4/1/21                 B/P               1,489,288
                                                                                                           -----------
                                                                                                            19,406,207
VIRGINIA(2.6%)
- ----------------------------------------------------------------------------------------------------------------------
  1,000,000   Fairfax Cnty., Indl. Dev. Auth. RIBS
              (Fairfax Hosp. Syst.), Ser. C, 10.327s, 8/29/23                              AA                1,198,750
  4,000,000   Roanoke, Indl. Dev. Auth. Hosp. RIBS                                                       
              (Roanoke Memorial Hosp.), Ser. B, MBIA, 8.38s, 7/1/20                        AAA               3,975,000
                                                                                                           -----------
                                                                                                             5,173,750
WASHINGTON(1.3%)
- ----------------------------------------------------------------------------------------------------------------------
  2,250,000   Grant Cnty., Pub. Hosp. Dist. No. 1 Rev. Bonds
              (Samaritan Hosp.), 9 1/4s, 9/1/10                                            BBB/P             2,497,500

WEST VIRGINIA(2.0%)
- ----------------------------------------------------------------------------------------------------------------------
  4,000,000   WV State Hosp. Fin. Auth. Hosp. Rev. Bonds
              (St. Francis Hosp.-Charleston), 7 3/4s, 8/15/13                              B                 3,900,000

              Total Investments (cost $189,612,815) (c)                                                   $192,188,523
                                                                                                          ============
</TABLE> 

(a) Percentages indicated are based on net assets of $197,325,888, which 
    correspond to a net asset value per share of $14.29.

(b) The Moody's or Standard & Poor's ratings indicated are believed to be the 
    most recent ratings available at May 31, 1994 for the securities listed.
    Ratings are generally ascribed to securities at the time of issuance. While
    the agencies may from time to time revise such ratings, they undertake no
    obligation to do so, and the ratings do not necessarily represent what the
    agencies would ascribe to these securities at May 31, 1994. Securities rated
    by Putnam are indicated by "/P" and are not publicly rated. Ratings are not
    covered by the Report of Independent Accountants.

(c) The aggregate identified cost for federal income tax purposes is 
    $189,612,815, resulting in gross unrealized appreciation and depreciation of
    $5,510,542 and $2,934,834 respectively, or net unrealized appreciation of
    $2,575,708.

The rates shown on Variable Rate Demand Notes (VRDN) and Residual Interest
    Bonds (RIBS) are the current interest rates at May 31, 1994, which are
    subject to change based on the terms of the security.

The accompanying notes are an integral part of these financial statements.

13
<PAGE>
 
STATEMENT OF ASSETS AND LIABILITIES
May 31, 1994 

<TABLE> 
<S>                                                               <C> 
ASSETS                                                       
- ------------------------------------------------------------------------------
Investments in securities, at value                          
(identified cost $189,612,815) (Note 1)                           $192,188,523
- ------------------------------------------------------------------------------
Cash                                                                   101,085
- ------------------------------------------------------------------------------
Interest receivable                                                  4,543,285
- ------------------------------------------------------------------------------
Receivable for securities sold                                       3,099,389
- ------------------------------------------------------------------------------
Unamortized organization expenses (Note 1)                              25,337
- ------------------------------------------------------------------------------
Total assets                                                      $199,957,619
- ------------------------------------------------------------------------------
LIABILITIES                                                  
- ------------------------------------------------------------------------------
Distributions payable to shareholders                             $  1,163,440
- ------------------------------------------------------------------------------
Payable for securities purchased                                     1,055,196
- ------------------------------------------------------------------------------
Payable for compensation of Manager (Note 3)                           345,084
- ------------------------------------------------------------------------------
Payable for compensation of Trustees (Note 3)                              197
- ------------------------------------------------------------------------------
Payable for investor servicing and custodian fees (Note 3)              57,650
- ------------------------------------------------------------------------------
Payable for administrative services (Note 3)                             1,518
- ------------------------------------------------------------------------------
Other accrued expenses                                                   8,646
- ------------------------------------------------------------------------------
Total liabilities                                                    2,631,731
- ------------------------------------------------------------------------------
Net Assets                                                        $197,325,888
- ------------------------------------------------------------------------------
REPRESENTED BY                                               
Paid-in capital                                                   $191,832,474
- ------------------------------------------------------------------------------
Undistributed net investment income                                  1,007,645
- ------------------------------------------------------------------------------
Accumulated net realized gain on investments                         1,910,061
- ------------------------------------------------------------------------------
Net unrealized appreciation of investments                           2,575,708
- ------------------------------------------------------------------------------
Total--Representing net assets applicable to                 
capital shares outstanding                                        $197,325,888
- ------------------------------------------------------------------------------
COMPUTATION OF NET ASSET VALUE                               
Net asset value, per share ($197,325,888 divided by          
13,807,168 shares)                                                      $14.29
- ------------------------------------------------------------------------------
</TABLE> 

The accompanying notes are an integral part of these financial statements.

14
<PAGE>
 
STATEMENT OF OPERATIONS
Year ended May 31, 1994 

<TABLE> 
<S>                                                               <C> 
- ------------------------------------------------------------------------------
TAX EXEMPT INTEREST INCOME                                         $15,399,643
- ------------------------------------------------------------------------------
EXPENSES:                                                       
- ------------------------------------------------------------------------------
Compensation of Manager (Note 3)                                   $ 1,436,467
- ------------------------------------------------------------------------------
Investor servicing and custodian fees (Note 3)                         289,008
- ------------------------------------------------------------------------------
Compensation of Trustees (Note 3)                                       12,915
- ------------------------------------------------------------------------------
Reports to shareholders                                                 22,519
- ------------------------------------------------------------------------------
Postage                                                                 15,176
- ------------------------------------------------------------------------------
Auditing                                                                27,356
- ------------------------------------------------------------------------------
Legal                                                                    5,799
- ------------------------------------------------------------------------------
Administrative services (Note 3)                                         6,728
- ------------------------------------------------------------------------------
Amortization of organization expenses (Note 1)                           8,395
- ------------------------------------------------------------------------------
Registration fees                                                          639
- ------------------------------------------------------------------------------
Exchange listing fees                                                   26,311
- ------------------------------------------------------------------------------
Other expenses                                                           4,710
- ------------------------------------------------------------------------------
Total expenses                                                       1,856,023
- ------------------------------------------------------------------------------
Net investment income                                               13,543,620
- ------------------------------------------------------------------------------
Net realized gain on investments (Notes 1 and 4)                     3,171,219
- ------------------------------------------------------------------------------
Net unrealized depreciation of investments                   
during the year                                                     (6,258,248)
- ------------------------------------------------------------------------------
Net loss on investments                                             (3,087,029)
- ------------------------------------------------------------------------------
Net increase in net assets resulting from operations               $10,456,591
- ------------------------------------------------------------------------------
</TABLE> 

The accompanying notes are an integral part of these financial statements.

15
<PAGE>
 
STATEMENT OF CHANGES IN NET ASSETS

<TABLE> 
<CAPTION> 
                                                                 For the period
                                                                  June 29, 1992
                                                                  (commencement
                                                 For the year    of operations) 
                                                 ended May 31         to May 31
- -------------------------------------------------------------------------------
                                                         1994              1993
INCREASE (DECREASE)IN NET ASSETS               
- -------------------------------------------------------------------------------
<S>                                             <C>               <C> 
Operations:                                    
- -------------------------------------------------------------------------------
Net investment income                           $  13,543,620     $  13,105,010
- -------------------------------------------------------------------------------
Net realized gain on investments                    3,171,219         2,238,349
- -------------------------------------------------------------------------------
Net unrealized appreciation (depreciation)     
of investments                                     (6,258,248)        8,833,956
- -------------------------------------------------------------------------------
Net increase in net assets                     
resulting from operations                          10,456,591        24,177,315
- -------------------------------------------------------------------------------
                                               
DISTRIBUTIONS TO SHAREHOLDERS FROM:            
- -------------------------------------------------------------------------------
Net investment income                             (13,984,155)      (11,656,830)
- -------------------------------------------------------------------------------
Net realized gain on                           
investments                                        (2,554,233)         (945,274)
- -------------------------------------------------------------------------------
Increase from capital share                    
transactions (Note 2)                                      --       191,732,474
- -------------------------------------------------------------------------------
Total (decrease) increase in net assets            (6,081,797)      203,307,685
                                               
NET ASSETS:                                    
- -------------------------------------------------------------------------------
Beginning of year                                 203,407,685           100,000
- -------------------------------------------------------------------------------
End of period (including undistributed         
net investment income of $1,007,645 and        
$1,448,180, respectively)                        $197,325,888      $203,407,685
- -------------------------------------------------------------------------------
                                               
NUMBER OF FUND SHARES                          
- -------------------------------------------------------------------------------
Shares outstanding at beginning of period          13,807,168             7,168
- -------------------------------------------------------------------------------
Shares issued in connection with            
initial offering                                           --        13,800,000
- -------------------------------------------------------------------------------
Shares outstanding at end of period                13,807,168        13,807,168
- -------------------------------------------------------------------------------
</TABLE> 

The accompanying notes are an integral part of these financial statements.

16
<PAGE>
 
FINANCIAL HIGHLIGHTS
(For a share outstanding throughout the period)

<TABLE> 
<CAPTION> 
                                                              For the period
                                                               June 29, 1992
                                                               (commencement
                                             Year ended    of operations) to
                                                 May 31               May 31
- ------------------------------------------------------------------------------
                                                   1994                 1993*
- ------------------------------------------------------------------------------
<S>                                          <C>           <C> 
Net Asset Value, Beginning of Period             $14.73                $13.89
- ------------------------------------------------------------------------------
Investment Operations                     
Net Investment Income                               .98                .95(a)
- ------------------------------------------------------------------------------
Net Realized and Unrealized               
Gain (Loss) on Investments                         (.22)                  .80
- ------------------------------------------------------------------------------
Total from Investment Operations                    .76                  1.75
- ------------------------------------------------------------------------------
Less Distributions from:                  
Net Investment Income                             (1.01)                (.84)
- ------------------------------------------------------------------------------
Net Realized Gain on Investments (Note 1)          (.19)                (.07)
- ------------------------------------------------------------------------------
Total Distributions                               (1.20)                (.91)
- ------------------------------------------------------------------------------
Net Asset Value, End of Period                   $14.29                $14.73
- ------------------------------------------------------------------------------
Market Value, End of Period                     $14.375               $14.625
- ------------------------------------------------------------------------------
Total Investment Return at                
Market Value (%) (b)                               6.46               4.08(c)
- ------------------------------------------------------------------------------
Net Assets, End of Period (in thousands)       $197,326              $203,408
- ------------------------------------------------------------------------------
Ratio of Expenses to Average              
Net Assets (%)                                      .91             .53(a)(c)
- ------------------------------------------------------------------------------
Ratio of Net Investment Income            
to Average Net Assets (%)                          6.58            7.27(a)(c)
- ------------------------------------------------------------------------------
Portfolio Turnover (%)                            36.92              69.11(d)
- ------------------------------------------------------------------------------
</TABLE> 

*   Represents initial net asset value of $13.95 less offering expenses of 
    approximately $0.06.

(a) Reflects a voluntary absorption of expenses incurred by the Fund. As a 
    result of this limitation, expenses for the period May 31, 1993 reflects a 
    reduction of $0.05 per share.  See Note 3.

(b) Total Investment return assumes dividend reinvestment and does not 
    reflect the effect of sales charges.

(c) Annualized.

(d) Not annualized.

17
<PAGE>
 
NOTES TO FINANCIAL STATEMENTS
May 31, 1994

NOTE 1
SIGNIFICANT ACCOUNTING POLICIES

The fund is registered under the Investment Company Act of 1940, as amended, 
as a diversified, closed-end management investment company. The fund seeks as 
high a level of current income exempt from federal income tax as Putnam 
Management believes is consistent with preservation of capital by investing 
primarily in a portfolio of health care tax-exempt securities. 

The following is a summary of significant accounting policies consistently 
followed by the fund in the preparation of its financial statements. The 
policies are in conformity with generally accepted accounting principles. 

A SECURITY VALUATION Tax-exempt bonds and notes are stated on the basis of
valuations provided by a pricing service, approved by the Trustees, which uses
information with respect to transactions in bonds, quotations from bond dealers,
market transactions in comparable securities and various relationships between
securities in determining value. The fair value of restricted securities is
determined by the Manager following procedures approved by the Trustees and such
valuations and procedures as reviewed periodically by Trustees.

B SECURITY TRANSACTIONS AND RELATED INVESTMENT INCOME Security transactions are
accounted for on the trade date (date the order to buy or sell is executed).
Interest income is recorded on the accrual basis.

C FEDERAL TAXES It is the policy of the fund to distribute all of its income
within the prescribed time and otherwise comply with the provisions of the
Internal Revenue Code applicable to regulated investment companies. It is also
the intention of the fund to distribute an amount sufficient to avoid imposition
of any excise tax under Section 4982 of the Internal Revenue Code of 1986.
Therefore, no provision has been made for federal taxes on income, capital gains
or unrealized appreciation of securities held and excise tax on income and
capital gains.

D DISTRIBUTIONS TO SHAREHOLDERS Distributions to shareholders are recorded by
the fund on the ex-dividend date.

E AMORTIZATION OF BOND PREMIUM AND DISCOUNT Any premium resulting from the
purchase of securities in excess of maturity value is amortized on a yield-to-
maturity basis. Discount on zero-coupon bonds is accreted according to the
effective yield method.

F UNAMORTIZED ORGANIZATION EXPENSES Expenses incurred by the fund in connection
with its organization and its registration with the Securities and Exchange
Commission and with various states, aggregated $41,646. These expenses are being
amortized over a five-year period based on a straight line basis.


NOTE 2
INITIAL CAPITALIZATION AND 
OFFERING OF SHARES

The fund was established as a Massachusetts business trust under the law of the
Commonwealth of Massachusetts on May 1, 1992. During the period May 1, 1992 to
June 26, 1992 the fund had no operations other than those related to
organizational matters, including the initial capital contribution of $100,000
and the

18
<PAGE>
 
issuance of 7,168 shares to Putnam Mutual Funds Corp., a wholly-owned 
subsidiary of Putnam Investments, Inc. on June 15, 1992.

On June 26, 1992, the fund completed the initial offering of 12,000,000 of 
its shares for which it received net proceeds of $166,622,474, after 
deducting $777,526 of initial offering expenses.  Such offering expenses were 
paid initially by Putnam Management.  On July 27, 1992, the fund received net 
proceeds of $25,110,000 from the supplementary offering of 1,800,000 shares.  
Regular investment operations commenced on June 29, 1992.

NOTE 3
MANAGEMENT FEE,
ADMISTRATIVE
SERVICES, AND
OTHER TRANSACTIONS

Compensation of Putnam Investment Management, Inc. ("Putnam Investment"), the 
fund's Manager, a wholly-owned subsidiary of Putnam Investments, Inc., for 
management and investment advisory services is paid quarterly based on the 
average net assets of the fund.  Effective December 19, 1992, such fee is 
based on the annual rate of 0.70% of average weekly net assets.  Prior to 
December 19, 1992 the Manager had voluntarily agreed to waive its management 
fee.

The fund also reimburses the Manager for the compensation and related 
expenses of certain officers of the fund and their staff who provide 
administrative services to the fund. The aggregate amount of all such 
reimbursements is determined annually by the Trustees. For the year ended May 
31, 1994, the fund paid $6,728 for these services.

Trustees of the fund receive an annual Trustee's fee of $800 and an 
additional fee for each Trustees' meeting attended. Trustees who are not 
interested persons of the Manager and who serve on committees of the Trustees 
receive additional fees for attendance at certain committee meetings. 

Custodial functions for the fund are provided by Putnam Fiduciary Trust 
Company (PFTC), a subsidiary of Putnam Investments, Inc. Investor servicing 
agent functions are provided by Putnam Investor Services, a division of PFTC. 
Fees paid for these investor servicing and custodial functions for the year 
ended May 31, 1994 amounted to $289,008.

Investor servicing and custodian fees reported in the Statement of operations 
for the year ended May 31, 1994 have been reduced by credits allowed by PFTC.

NOTE 4
PURCHASES AND
SALES OF SECURITIES

During the year ended May 31, 1994, purchases and sales of investment 
securities  other than short-term municipal obligation aggregated $74,877,358 
and $91,367,021 respectively.  Purchases and sales of short-term municipal 
obligations aggregated $10,680,000 and $8,890,000 respectively.  In 
determining the net gain or loss on securities sold, the cost of securities 
has been determined on the identified cost basis.

19
<PAGE>
 
SELECTED QUARTERLY DATA
(UNAUDITED)

<TABLE> 
<CAPTION> 
- -------------------------------------------------------------------------------------------

                                                         Three months ended
- -------------------------------------------------------------------------------------------
                                   May 31      February 28      November 30       August 31
- -------------------------------------------------------------------------------------------
                                     1994            1994              1993            1993
- -------------------------------------------------------------------------------------------
<S>                          <C>             <C>               <C>             <C> 
TOTAL INVESTMENT           
INCOME                     
Total                        $  3,775,827    $  3,833,864      $  3,883,176    $  3,906,776
Per share                    $        .27    $        .28      $        .27    $        .29
- -------------------------------------------------------------------------------------------
NET INVESTMENT             
INCOME                     
Total                        $  3,339,676    $  3,373,354      $  3,414,063    $  3,416,527
Per share                    $        .24    $        .25      $        .24    $        .25
- -------------------------------------------------------------------------------------------
NET REALIZED AND           
UNREALIZED GAIN (LOSS)     
ON INVESTMENTS             
Total                        $ (8,917,744)   $   (264,663)     $  1,802,283    $  4,293,095
Per share                    $       (.65)   $       (.02)     $        .14    $        .31
- -------------------------------------------------------------------------------------------
NET INCREASE (DECREASE)    
IN ASSETS RESULTING FROM   
OPERATIONS                 
Total                        $ (5,578,068)   $  3,108,691      $  5,216,346    $  7,709,622                                     
Per share                    $       (.41)   $        .23      $        .38    $        .56                                  
- -------------------------------------------------------------------------------------------
NET ASSETS AT THE          
END OF THE PERIOD          
Total                        $197,325,888    $206,407,850      $209,341,170    $207,629,192
Per share                    $      14.29    $      14.95      $      15.16    $      15.04                                    
- -------------------------------------------------------------------------------------------
</TABLE> 

20
<PAGE>
 
<TABLE> 
<CAPTION> 
                                                                             For the period
                                                                              June 29, 1992
- -------------------------------------------------------------------------------------------
                                                                              (commencement
                                                                          of operations) to
- -------------------------------------------------------------------------------------------
                                   May 31      February 28      November 30       August 31                
- -------------------------------------------------------------------------------------------
                                     1993            1993              1992            1992
- -------------------------------------------------------------------------------------------
<S>                          <C>             <C>               <C>             <C> 
TOTAL INVESTMENT          
INCOME                    
Total                        $  3,880,955    $  3,867,862      $  3,893,481    $  2,419,259                  
Per share                    $        .28    $        .28      $        .29    $        .17            
- -------------------------------------------------------------------------------------------
NET INVESTMENT            
INCOME                                                                                                       
Total                        $  3,414,250    $  3,540,227      $  3,765,663    $  2,384,870             
Per share                    $        .25    $        .25      $        .28    $        .17             
- -------------------------------------------------------------------------------------------
NET REALIZED AND          
UNREALIZED GAIN (LOSS)                                                                                  
ON INVESTMENTS                                                                                          
Total                        $ (1,139,899)   $  8,705,014      $    (57,854)   $  3,565,044             
Per share                    $       (.08)   $        .63      $       (.01)   $        .26             
- -------------------------------------------------------------------------------------------
NET INCREASE (DECREASE)                                                                                   
IN ASSETS RESULTING FROM                                                                                 
OPERATIONS                
Total                        $  2,274,351    $ 12,245,241      $  3,707,809    $  5,949,914              
Per share                    $        .17    $        .88      $        .27    $        .43                
- -------------------------------------------------------------------------------------------
NET ASSETS AT THE         
END OF THE PERIOD         
Total                        $203,407,685    $204,627,026      $196,953,640    $196,620,029            
Per share                    $      14.73    $      14.82      $      14.26    $      14.24            
- -------------------------------------------------------------------------------------------
</TABLE> 

21
<PAGE>
 
FEDERAL TAX INFORMATION

The fund has designated all net investment income distributions paid during the
fiscal year as exempt-interest dividends. Thus, 100% of these distributions are
exempt from federal income tax and personal income tax. The fund also paid a
short-term capital gain of $0.185. The Form 1099 you will receive in January
1995 will tell you the tax status of any distributions paid to your account in
calendar 1994. The income earned from each state will also be reported to you at
this time.

22
<PAGE>
 
FUND INFORMATION

INVESTMENT MANAGER

Putnam Investment
Management, Inc.
One Post Office Square
Boston, MA 02109

MARKETING SERVICES

Putnam Mutual Funds Corp.
One Post Office Square
Boston, MA 02109

CUSTODIAN

Putnam Fiduciary Trust Company

LEGAL COUNSEL

Ropes & Gray

INDEPENDENT ACCOUNTANTS

Price Waterhouse

TRUSTEES

George Putnam, Chairman 
William Pounds, Vice Chairman
Jameson Adkins Baxter
Hans H. Estin 
John A. Hill
Elizabeth T. Kennan
Lawrence J. Lasser
Donald S. Perkins
Robert E. Patterson
George Putnam, III
A.J.C. Smith
W. Nicholas Thorndike

OFFICERS

George Putnam
President 

Charles E. Porter
Executive Vice President

Patricia C.Flaherty
Senior Vice President

Lawrence J. Lasser
Vice President

Gordon H. Silver
Vice President

Gary N. Coburn
Vice President

James E. Erickson
Vice President

Howard K. Manning
Vice President and Fund Manager

William N. Shiebler
Vice President

John R. Verani
Vice President

Paul O'Neil
Vice President

John D. Hughes
Vice President and Treasurer

Beverly Marcus
Clerk and Assistant Treasurer

This report is for the information of shareholders of Putnam Tax-Free Health 
Care Fund. It may also be used as sales literature when preceded or 
accompanied by the current prospectus, which gives details of sales charges, 
investment objectives, and operating policies of the fund.

23
<PAGE>
 
PUTNAM INVESTMENTS                                            Bulk Rate        
                                                              U.S. Postage Paid
THE PUTNAM FUNDS                                              Boston, MA       
One Post Office Square                                        Permit No. 53749  
Boston, Massachusetts 02109




168-12998


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