Patient information

Kalluri Chandramouli

Simulated actor
Patient Identity Source
Last modifier
Anonymous
Last modified date
12/8/20 12:32:47 PM (CET GMT+0100)
First name
Kalluri
Last name
Chandramouli
Mother's maiden name
Emankum
Gender
F
Date of Birth
1/25/67
Marital status
Identity Reliability Code

Home

Country
IND
Patient Identifiers
  • 5604^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO (PI)
Email
Primary Residence Number
555-123-1212
Account number
AN9726^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
5868b114-f0eb-4d0d-be2e-666cde016c91
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1967
Date de naissance corrigé
No
Mode d'obtention de l'identité
Justificatif d'identité
Valide jusqu'au
Date d'interrogation du téléservice INSi
Patient history
  • 2020-12-08 12:33:40.217 - Patient has been created
  • 2020-12-08 12:33:41.806 - Patient has been sent to SUT (1.3.6.1.4.1.21367.13.50.99 1.3.6.1.4.1.21367.13.30.92) within a PRPA_IN201301UV02 message
Visit number
Patient status
Patient class
Last modified date
Action
VN12987^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 6/11/21 1:20:05 PM (CEST GMT+0200)