Patient information

EHR_NEXTGEN_2020 OTHER_R+C_CIE_2020

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
1/21/20 3:59:29 PM (CET GMT+0100)
Warning: this patient is no more active and cannot be updated anymore
First name
EHR_NEXTGEN_2020
Last name
OTHER_R+C_CIE_2020
Mother's maiden name
Williams
Gender
Female
Date of Birth
6/17/50
Religion
Christian: Roman Catholic
Race
White
Marital status
Identity Reliability Code

Home

Street address line
Carter Henry Drive
Zip Code
06834
City
Fairfield
State
Connecticut
Country
USA
Patient Identifiers
  • DDS-66215^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
  • IHEBLUE-3017^^^IHEBLUE&1.3.6.1.4.1.21367.13.20.3000&ISO (PI)
  • IHEFACILITY-3017^^^IHEFACILITY&1.3.6.1.4.1.21367.3000.1.6&ISO (PI)
  • IHEGREEN-3017^^^IHEGREEN&1.3.6.1.4.1.21367.13.20.2000&ISO (PI)
  • IHERED-3017^^^IHERED&1.3.6.1.4.1.21367.13.20.1000&ISO (PI)
Email
Account number
AN9258^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
abdf557d-bfbe-45bb-a691-2131f68858c1
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1950
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
  • 2020-01-21 15:59:58.47 - Patient has been created
  • 2020-03-02 14:44:16.67 - Patient has been changed Id patient #13012 by fgatto
Visit number
Patient status
Patient class
Last modified date
Action