Patient information

Guus Born

Simulated actor
Patient Demographic Supplier
Last modifier
Mary Iannuzzi
Last modified date
11/11/21 1:59:00 PM (CET GMT+0100)
First name
Guus
Last name
Born
Mother's maiden name
Tappan
Gender
Male
Date of Birth
4/20/86
Marital status
Identity Reliability Code

Home

Street address line
Ten Ankerweg
Zip Code
4691GX
City
Tholen
Country
NLD
Patient Identifiers
  • DDS-72743^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN10704^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
c0704dc8-ed2e-4822-b79f-08bc77c2a05a
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1986
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
  • 2021-11-11 13:59:05.879 - Patient has been created by m.trabace
  • 2021-11-22 21:05:58.85 - Patient has been sent to SUT (FORTH_ICS DEMO_FORTH_ICS) within a ADT^A28^ADT_A05 message by kostoman
Visit number
Patient status
Patient class
Last modified date
Action