Patient information

GRACE SOURCE-TWENTYSEVEN

Simulated actor
Patient Demographic Supplier
Last modifier
Filippo Gatto
Last modified date
9/12/22 5:42:30 PM (CEST GMT+0200)
First name
GRACE
Last name
SOURCE-TWENTYSEVEN
Mother's maiden name
Morris
Gender
Female
Date of Birth
1/16/04
Religion
Christian: Roman Catholic
Race
Native Hawaiian or Pacific Islander
Marital status
Identity Reliability Code

Home

Country
USA
Patient Identifiers
  • DDS-73425^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
  • IHERED-2645^^^IHERED&1.3.6.1.4.1.21367.13.20.1000&ISO^PI (PI)
Email
Account number
AN11281^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
4534fa77-c2c7-4199-a4a7-cd2cd386fe4e
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 2004
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
  • 2022-09-12 17:44:49.359 - Patient has been created by fgatto
  • 2022-09-12 17:44:49.535 - Patient has been sent to SUT (TESI OF_TESI_WEBLAB) within a ADT^A28^ADT_A05 message by fgatto
Visit number
Patient status
Patient class
Last modified date
Action