Patient information

WILLIAM WALTERS

Simulated actor
Patient Identity Cross-Reference Manager
Last modifier
1.3.6.1.4.1.21367.2011.2.5.5597
Last modified date
9/9/22 12:30:52 PM (CEST GMT+0200)
First name
WILLIAM
Last name
WALTERS
Gender
Male
Date of Birth
5/4/55
Marital status
Identity Reliability Code

Home

Street address line
3900 FLORA PL.
City
ST. LOUIS
State
MO
Patient Identifiers
  • IHEFACILITY-9712^^^CGEU&1.3.6.1.4.1.21367.2011.2.5.5597&
  • IHEFACILITY-9717^^^CGEU&1.3.6.1.4.1.21367.2011.2.5.5597&
Email
Primary Residence Number
tel:0123/456789;ext=4321
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
46d750ab-8b5f-43f0-bf5d-b75c091e2a03
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- -
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