Patient information

Charles Yi

Simulated actor
Patient Encounter Supplier
Last modifier
Georgios Kavlentakis
Last modified date
4/25/24 12:32:08 PM (CEST GMT+0200)
First name
Charles
Last name
Yi
Mother's maiden name
Lantz
Gender
Male
Date of Birth
12/10/75
Religion
Christian: Protestant
Race
Black or African American
Marital status
Identity Reliability Code

Home

Street address line
West 200 South
Zip Code
84089
City
Clearfield
State
Utah
Country
USA
Patient Identifiers
  • DDS-74599^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
  • IHEBLUE-3339^^^IHEBLUE&1.3.6.1.4.1.21367.13.20.3000&ISO (PI)
  • IHEFACILITY-3339^^^IHEFACILITY&1.3.6.1.4.1.21367.3000.1.6&ISO (PI)
  • IHEGREEN-3339^^^IHEGREEN&1.3.6.1.4.1.21367.13.20.2000&ISO (PI)
  • IHERED-3339^^^IHERED&1.3.6.1.4.1.21367.13.20.1000&ISO (PI)
Email
Account number
AN11929^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
bc5fbe3d-509c-4e57-aa92-c86f1ae7a2df
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1975
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
VN15353^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^VN ADMITTED I 4/25/24 12:32:24 PM (CEST GMT+0200)