Patient information

Thomas Mendez

Simulated actor
Patient Identity Source
Last modifier
Anonymous
Last modified date
5/2/19 7:23:54 AM (CEST GMT+0200)
First name
Thomas
Last name
Mendez
Mother's maiden name
Rife
Gender
Male
Date of Birth
6/23/84
Religion
Christian: Protestant
Race
White
Marital status
Identity Reliability Code

Home

Street address line
West Flagler Street
Zip Code
33174
City
Sweetwater
State
Florida
Country
USA
Patient Identifiers
  • DDS-65570^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN8885^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
782b448f-f30b-4b9a-8008-38c97877ccf4
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1984
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
  • 2019-05-02 07:24:07.656 - Patient has been created
  • 2019-05-02 07:24:11.467 - Patient has been sent to SUT (1.3.6.1.4.1.12559.11.1.2.2.5.1 1.3.6.1.4.1.12559.11.1.2.2.5.11) within a PRPA_IN201301UV02 message
Visit number
Patient status
Patient class
Last modified date
Action
VN13679^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 1/31/22 11:54:54 AM (CET GMT+0100)