Patient information

chpf0624-2 chpl0624-2

Simulated actor
Patient Identity Source
Last modifier
Anonymous
Last modified date
6/24/22 10:30:03 AM (CEST GMT+0200)
First name
chpf0624-2
Last name
chpl0624-2
Mother's maiden name
chpm0624
Gender
Male
Date of Birth
2/4/90
Marital status
Common law
Identity Reliability Code

Home

Street address line
Kaneelstraat
Zip Code
5431DV
City
Cuijk
Country
NLD
Patient Identifiers
  • DDS-73114^^^WWW&12.123&ISO (PI)
Email
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
2d586b67-cca4-43ab-afcb-05d396d355d7
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1990
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
  • 2022-12-28 06:38:49.504 - 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_IN201304UV02 message
Visit number
Patient status
Patient class
Last modified date
Action
VN14136^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 6/24/22 7:18:48 AM (CEST GMT+0200)