THIS SECURITY IS A GLOBAL SECURITY WITHIN THE MEANING OF THE INDENTURE

HEREINAFTER REFERRED TO AND IS REGISTERED IN THE NAME OF A DEPOSITARY OR A

NOMINEE OF A DEPOSITARY. THIS SECURITY IS EXCHANGEABLE FOR SECURITIES REGISTERED

IN THE NAME OF A PERSON OTHER THAN THE DEPOSITARY OR ITS NOMINEE ONLY IN THE

LIMITED CIRCUMSTANCES DESCRIBED IN THE INDENTURE AND MAY NOT BE TRANSFERRED

EXCEPT AS A WHOLE BY THE DEPOSITARY TO A NOMINEE OF SUCH DEPOSITARY OR BY A

NOMINEE OF SUCH DEPOSITARY TO SUCH DEPOSITARY OR ANOTHER NOMINEE OF SUCH

DEPOSITARY OR BY SUCH DEPOSITARY OR ANY SUCH NOMINEE TO A SUCCESSOR OF SUCH

DEPOSITARY OR A NOMINEE OF SUCH SUCCESSOR.



Unless this certificate is presented by an authorized representative of The

Depository Trust Company, a New York corporation ("DTC"), to the Company or its

agent for registration of transfer, exchange or payment, and any certificate

issued is registered in the name of Cede & Co. or in such other name as is

requested by an authorized representative of DTC (and any payment is made to

Cede & Co. or to such other entity as is requested by an authorized

representative of DTC), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR

OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch as the registered owner

hereof, Cede & Co., has an interest herein.



                                                                Principal Amount

R19

                                     HCA INC.                       $350,000,000



                         5.25% NOTE DUE NOVEMBER 6, 2008



                                   GLOBAL NOTE



                                                                 CUSIP 404119AK5



         HCA Inc. (f/k/a HCA - The Healthcare Company), a corporation duly

organized and existing under the laws of the State of Delaware (herein called

the "Company," which term includes any successor corporation under the Indenture

hereinafter referred to), for value received, hereby promises to pay to Cede &

Co., as the nominee of DTC, or registered assigns, the principal amount of Three

Hundred Fifty Million Dollars ($350,000,000), on November 6, 2008 (the "Maturity

Date") and to pay interest (computed on the basis of a 360-day year of twelve

30-day months) on May 6 and November 6 in each year (each, an "Interest Payment

Date"), beginning on May 6, 2004, and at the Maturity Date specified above on

said principal amount, at the rate of 5.25% per annum, from November 6, 2003

until payment of said principal amount has been made or duly provided for. The

interest so payable on any Interest Payment Date (other than at maturity) will

be paid to the Person in whose name this Global Note is





{PAGE}



registered at the close of business on the twenty-first day of the month prior

to the month in which such interest payment is due (a "Regular Record Date"),

unless the Company shall default in the payment of interest due on any such

Interest Payment Date, in which case such defaulted interest shall be paid to

the Person in whose name this Global Note is registered at the close of business

on a Special Record Date for the payment of such defaulted interest established

by notice to the registered holders of Notes (as hereinafter defined) not less

than ten days preceding such Special Record Date. In any case where the date for

any payment on the Notes is not a Business Day, such payment shall be made on

the next succeeding Business Day. A Business Day is any day that is not a

Saturday or Sunday and that, in The City of New York, New York, is not a day on

which banking institutions are generally authorized or required by law or

executive order to close.



         Both principal of and interest on this Global Note are payable in

immediately available funds in any coin or currency of the United States of

America, which at the time of payment is legal tender for the payment of public

and private debts. Payments of principal and interest will be made in The City

of New York, New York, at the Corporate Trust Office of The Bank of New York, or

at such other office or agency of the Company as the Company shall designate

pursuant to the Indenture referred to elsewhere herein.



         This Global Note is a duly authorized issue of debentures, notes, bonds

or other evidences of indebtedness of the Company (the "Securities"), of the

series hereinafter specified, issued or to be issued under an Indenture dated as

of December 16, 1993, as supplemented, as may be amended by indentures

supplemental thereto (the "Indenture"), duly executed and delivered by the

Company to The Bank of New York, the successor to Bank One Trust Company, N.A.,

who was in turn the successor to The First National Bank of Chicago, as trustee

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