Patient information

Miladka Dvořák

Simulated actor
Patient Identity Source
Last modifier
Ioannis Petrakis
Last modified date
2/26/21 9:59:42 AM (CET GMT+0100)
First name
Miladka
Last name
Dvořák
Mother's maiden name
Mach
Gender
Female
Date of Birth
9/12/55
Marital status
Identity Reliability Code

Home

Street address line
Havlíčkovo nábř.
Zip Code
67401
City
Třebíč
Country
CZE
Patient Identifiers
  • DDS-71836^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
  • 12345^^^1.3.6.1.4.1.21367.2005.3.7&ISO
Email
Account number
AN10024^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
89128a79-4717-4130-85dd-ced04512d808
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1955
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
  • 2021-02-26 10:01:29.271 - Patient has been created by petrakis
  • 2021-02-26 10:01:29.303 - Patient has been sent to SUT (IHE PatientManager) within a ADT^A28^ADT_A05 message by petrakis
Visit number
Patient status
Patient class
Last modified date
Action
VN12673^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 4/6/21 4:21:29 PM (CEST GMT+0200)