On September 06, 2017 a
Party Statement
was filed
involving a dispute between
Hubbard, Patricia,
and
Luna, Leonardo,
for MOTOR VEHICLE ACCIDENT
in the District Court of Dallas County.
Preview
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DALLAS COUNTY
1/26/2018 11:47 AM
FELICIA PITRE
DISTRICT CLERK
CAUSE NO. DC-17-11588
PATRICIA HUBBARD § IN THE DISTRICT COURT
Plaintiff,
Vv. DALLAS COUNTY, TEXAS
LEONARDO LUNA.
Defendant. 116™ JUDICIAL DISTRICT
THE STATE OF TEXAS
COUNTY OF DALLAS
MEDICAL RECORDS AFFIDAVIT
BEFORE ME, the undersigned authority, personally appeared Margie L. Powe who, by me being
duly sworn by me, upon his/her oath stated:
“My name is Margie L. Powe. I am over 18 years of age, of sound mind and capable of making
this affidavit, and personally acquainted with the facts herein stated:
1 am the Custodian of Medical Records for Baylor University Medical Center at Dallas, 3500
Gaston Ave, Dallas, Texas 75246 (“Baylor”), Attached hereto are 24 pages of records from
Baylor concerning PATRICIA HUBBARD.
These pages are kept by Baylor in the regular course of business, and it was the regular course of
business of Baylor for an employee or representative, or a healthcare provider permitted to
practice in Baylor, with knowledge of the act, event, condition, opinion or diagnosis recorded to
make the record or to transmit information thereof to be included in such record; and the record
was made at or near the time or reasonably soon thereafter. The services provided were
necessary and reasonable at the time and place that the services were provided. The records
attached are exact duplicates of the original, as it is a policy of Baylor not to permit the originals
to leave the campus. The records attached are certified from NOVEMBER 09, 2017 to the date
of this affidavit as signed below.”
SIGNED on this 17 day of JANUARY. 2018.
ap
SUBSCRIBED TO AND SWORN BEFORE ME, the undersigned Notary Public, in and for the
State of Texas, on the 17 day of, JANUARY, 2018, to which witness my hand and seal of office,
ss KRISTI DESHON GORMAN
Notary Public, State of Texas
TR e
e Te
My Commission Expires
April 15, 2018 Pacman
Notary Public
129785491 Mv Commission Expires: April 15, 2018
Document Filed Date
January 26, 2018
Case Filing Date
September 06, 2017
Category
MOTOR VEHICLE ACCIDENT
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| DALLAS COUNTY 1/26/2018 11:47 AM FELICIA PITRE DISTRICT CLERK CAUSE NO. DC-17-11588 PATRICIA HUBBARD § IN THE DISTRICT COURT Plaintiff, Vv. DALLAS COUNTY, TEXAS LEONARDO LUNA. Defendant. 116™ JUDICIAL DISTRICT THE STATE OF TEXAS COUNTY OF DALLAS MEDICAL RECORDS AFFIDAVIT BEFORE ME, the undersigned authority, personally appeared Margie L. Powe who, by me being duly sworn by me, upon his/her oath stated: “My name is Margie L. Powe. I am over 18 years of age, of sound mind and capable of making this affidavit, and personally acquainted with the facts herein stated: 1 am the Custodian of Medical Records for Baylor University Medical Center at Dallas, 3500 Gaston Ave, Dallas, Texas 75246 (“Baylor”), Attached hereto are 24 pages of records from Baylor concerning PATRICIA HUBBARD. These pages are kept by Baylor in the regular course of business, and it was the regular course of business of Baylor for an employee or representative, or a healthcare provider permitted to practice in Baylor, with knowledge of the act, event, condition, opinion or diagnosis recorded to make the record or to transmit information thereof to be included in such record; and the record was made at or near the time or reasonably soon thereafter. The services provided were necessary and reasonable at the time and place that the services were provided. The records attached are exact duplicates of the original, as it is a policy of Baylor not to permit the originals to leave the campus. The records attached are certified from NOVEMBER 09, 2017 to the date of this affidavit as signed below.” SIGNED on this 17 day of JANUARY. 2018. ap SUBSCRIBED TO AND SWORN BEFORE ME, the undersigned Notary Public, in and for the State of Texas, on the 17 day of, JANUARY, 2018, to which witness my hand and seal of office, ss KRISTI DESHON GORMAN Notary Public, State of Texas TR e e Te My Commission Expires April 15, 2018 Pacman Notary Public 129785491 Mv Commission Expires: April 15, 2018