Patient information

chpf0624-1 chpl0624-1

Simulated actor
Patient Identity Source
Last modifier
Anonymous
Last modified date
6/24/22 10:32:28 AM (CEST GMT+0200)
First name
chpf0624-1
Last name
chpl0624-1
Mother's maiden name
chpm0624
Gender
Female
Date of Birth
1/8/47
Marital status
Identity Reliability Code

Home

Street address line
Christuslaan
Zip Code
8940
City
Wervik
Country
BEL
Patient Identifiers
  • DDS-73113^^^WWW&12.123&ISO (PI)
Email
Primary Residence Number
1234567890
Account number
AN11041^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
1f8f5e95-46c1-4462-806d-5ec9f8907487
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1947
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
Visit number
Patient status
Patient class
Last modified date
Action
VN14135^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 6/24/22 7:08:09 AM (CEST GMT+0200)