Patient information

Pravoslav01 Novotný

Simulated actor
Patient Demographic Supplier
Last modifier
Mary Iannuzzi
Last modified date
8/4/21 3:04:11 PM (CEST GMT+0200)
First name
Pravoslav01
Last name
Novotný
Mother's maiden name
Procházka
Gender
Male
Date of Birth
9/28/72
Marital status
Identity Reliability Code

Home

Street address line
U Věžových domů
Zip Code
43401
City
Most
Country
CZE
Patient Identifiers
  • DDS-72543^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN10567^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
d876ce74-9cc7-4e0c-bbe3-46e3ead6a42e
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1972
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
  • 2021-08-04 15:04:17.744 - Patient has been created by m.trabace
  • 2021-08-04 15:04:17.747 - Patient has been sent to SUT (nuvyta nuplatform) within a ADT^A31^ADT_A05 message by m.trabace
Visit number
Patient status
Patient class
Last modified date
Action