EXHIBIT 4


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 OR 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.



R2                                                              Principal Amount

                      COLUMBIA/HCA HEALTHCARE CORPORATION           $200,000,000

                           7% NOTE DUE JULY 1, 2007

                                  GLOBAL NOTE

                                                                CUSIP 197677 AL1


     COLUMBIA/HCA HEALTHCARE CORPORATION, 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 The Depository Trust Company, or registered assigns, the principal
amount of Two Hundred Million Dollars ($200,000,000), on July 1, 2007 (the
"Maturity Date") and to pay interest (computed on the basis of a 360-day year of
twelve 30-day months) on January 1 and July 1 ("Interest Payment Date") in each
year, beginning on January 1, 1998, and at the Maturity Date specified above on
said principal amount, at the rate of 7% per annum, from June 30, 1997 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 registered at the close
of business on the last day of the month immediately preceding the month in
which such interest payment is due (a "Regular Record Date"), next preceding
such Interest Payment 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 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 Chicago, Illinois,
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 Chicago,
Illinois, at the Corporate Trust Office of The First National Bank of Chicago,
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 one of a duly authorized issue of debentures, notes,
bonds or other evidences of indebtedness of the Company (hereinafter called the
"Securities"), of the series hereinafter specified, issued or to be issued under
an Indenture dated as of December 15, 1993, as may be amended by indentures
supplemental thereto (hereinafter called the "Indenture"), duly executed and
delivered by the Company to The First National Bank of Chicago, as trustee
(hereinafter called the "Trustee"), to which Indenture reference is hereby made
for a description of the respective rights and duties thereunder of the Trustee,
the Company and the Holders of the Securities.  The Securities may be issued in
one or more series, which different series may be issued in various aggregate
principal amounts, may mature at different times, may bear interest at different
rates, may have different conversion prices (if any), may be subject to
different redemption provisions, may be subject to different sinking, purchase
or analogous funds, may be subject to different covenants and Events of Default
and may otherwise vary as in the Indenture provided.  This Global Note is a
Global Security representing the entire principal amount of a series of
Securities designated "7% Notes due July 1, 2007" (hereincalled the "Notes")
issued under the Indenture.  Unless otherwise provided herein, all terms used in
this Global Note, which are defined in the Indenture shall have the meanings
assigned to them in the Indenture.

     The Notes do not have a sinking fund.

     The Notes may not be redeemed by the Company prior to maturity.

     In case an Event of Default with respect to the Notes shall have occurred
and be continuing, the principal hereof may be declared, and upon such
declaration shall become, immediately due and payable, in the manner, with the
effect and subject to the conditions provided in the Indenture.  The Indenture
provides that such declaration may in certain events be waived by the Holders of
a majority in principal amount of the Notes then Outstanding.

     The Indenture permits, with certain exceptions as therein provided, the
amendment thereof and the modification of the rights and obligations of the
Company and the rights of the Holders 

                                       2

 
of the Securities of each series to be affected under the Indenture at any time
by the Company and the Trustee with the consent of the Holders of not less than
a majority in principal amount of the outstanding Securities of each series to
be affected. It is also provided in the Indenture that prior to any declaration
accelerating the maturity of the Notes as a series, the Holders of a majority in
aggregate principal amount of the Securities of such series at the time
Outstanding may on behalf of the Holders of all of the Securities of such series
waive any past default with respect to the Securities of such series under the
Indenture and its consequences, except a default in the payment of the principal
of, or interest on, any of the Securities of such series.

     No reference herein to the Indenture and no provision of this Global Note
or of the Indenture (including the Company's right to defease and discharge the
Notes pursuant to Article Four and Article Fourteen of the Indenture) shall
alter or impair the obligation of the Company, which is absolute and
unconditional, to pay the principal of, and interest on, this Global Note at the
place, at the respective times, at the rate and in the coin or currency herein
prescribed.

     This Global Note shall be exchangeable for Securities registered in the
names of Persons other than the Depositary or its nominee only if (i) the
Depositary notifies the Company that it is unwilling or unable to continue as
the Depositary or if at any time the Depositary ceases to be registered or in
good standing under the United States Securities Exchange Act of 1934, as
amended, and the Company fails to appoint a successor Depositary within 90 days
after the Company receives such notice or becomes aware of such event, (ii) the
Company executes and delivers to the Trustee a Company Order that this Global
Note shall be so exchangeable or (iii) there shall have occurred and be
continuing an Event of Default, or an event which, with the giving of notice or
the lapse of time, or both, would constitute an Event of Default, with respect
to the Notes.  To the extent that this Global Note is exchangeable pursuant to
the preceding sentence, it shall be exchangeable for Notes registered in such
names as the Depositary shall direct.

     Except as provided in the immediately preceding paragraph, this Global Note
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.

     Prior to due presentment for registration of transfer of this Global Note,
the Company, the Trustee and any agent of the Company or the Trustee may deem
and treat the Holder hereof as the absolute owner of this Global Note (whether
or not this Global Note shall be overdue and notwithstanding any notation of
ownership or other writing hereon), for the purpose of receiving payment hereof
or on account hereof (except as otherwise provided in the Indenture), as herein
provided, and for all other purposes, and neither the Company nor the Trustee
nor any Paying Agent nor any Security Registrar shall be affected by any notice
to the contrary.  All payments made to or upon the order of such Holder shall,
to the extent of the sum or sums paid, effectually satisfy and discharge
liability for moneys payable on this Global Note.

     None of the Company, the Trustee, any Paying Agent or the Security
Registrar will have any responsibility or liability for any aspect of the
records relating to or payments made on 

                                       3

 
account of beneficial ownership interests of this Global Note or for
maintaining, supervising or reviewing any records relating to such beneficial
ownership interests.

     No recourse for the payment of the principal of, or interest on, this
Global Note, or for any claims based hereon or otherwise in respect hereof, and
no recourse under or upon any obligation, covenant or agreement of the Company
in the Indenture or any indenture supplemental thereto or in any Note or because
of the creation of any indebtedness represented thereby, shall be had against
any incorporator, stockholder, officer or director, as such, past, present or
future, of the  Company, whether by virtue of any assessment or penalty or
otherwise, all such liability being, by the acceptance hereof and as part of the
consideration for the issue hereof, expressly waived and released.

     Except as otherwise expressly provided in this Global Note, this Global
Note shall in all respects be entitled to all benefits, and subject to the same
terms and conditions, as definitive registered securities authenticated and
delivered under the Indenture.

     The Indenture and this Global Note shall be governed by and construed in
accordance with the laws of the State of New York.

     This Global Note shall not be valid or become obligatory for any purpose
until the certificate of authentication hereon shall have been signed by the
Trustee under the Indenture referred to on the reverse hereof.

                                       4

 
     IN WITNESS WHEREOF, the Company has caused this instrument to be duly
executed under its corporate seal.


Dated as of June 30, 1997               COLUMBIA/HCA HEALTHCARE
                                         CORPORATION


                               By:
                                  ----------------------------------------------
                               Title:     President
                                     -------------------------------------------


                               Attest:
                                      ------------------------------------------
                               Title:     Secretary
                                     -------------------------------------------


TRUSTEE'S CERTIFICATE
OF AUTHENTICATION

This is one of the Securities
of the series designated herein
referred to in the within-
mentioned Indenture.

THE FIRST NATIONAL BANK OF CHICAGO,
as Trustee


By:
   -------------------------------

                                       5