Paragraph 1Purpose
You wrote
I am writing to refer Mr Hughes, 58-year-old accountant, who is complaining from chest pain since three weeks.
Better
I am writing to refer Mr Hughes, a 58-year-old accountant, for urgent assessment of suspected stable angina.
Why: The opening must give the reason for the referral and its urgency, not only the symptom. Dr Lee should know what you want from her in the first sentence.
Paragraph 3Content
Left out of your letter
Better
His total cholesterol was raised at 6.8 mmol/L.
Why: The case notes give a raised cholesterol. It is a cardiac risk factor, so the cardiologist needs it. Leaving it out costs you on Content.
Paragraph 1Language
You wrote
58-year-old accountant
Better
a 58-year-old accountant
Why: A singular countable noun needs an article. Rule: a/an before a singular job or description the first time you mention it.