Patient information

David Wheaton

Simulated actor
Patient Identity Source
Last modifier
Meenal T
Last modified date
4/30/19 1:26:25 PM (CEST GMT+0200)
First name
David
Last name
Wheaton
Mother's maiden name
Barela
Gender
Male
Date of Birth
12/6/61
Religion
Christian: Protestant
Race
White
Marital status
Identity Reliability Code

Home

Street address line
Dowling Court
Zip Code
32114
City
Daytona Beach
State
Florida
Country
USA
Patient Identifiers
  • DDS-65567^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN8884^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
54194cf5-4039-43d2-af42-f5514e3f4b8c
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1961
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
  • 2019-04-30 13:26:28.181 - Patient has been created by meenal
  • 2019-04-30 13:26:31.913 - 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 by meenal
  • 2019-04-30 16:25:51.344 - Patient has been sent to SUT (IHE PatientManager) within a ADT^A28^ADT_A05 message
Visit number
Patient status
Patient class
Last modified date
Action
VN13683^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 1/31/22 12:08:04 PM (CET GMT+0100)