Patient information

Broněk Dvořák

Simulated actor
ADT
Last modifier
Anonymous
Last modified date
5/28/21 8:57:00 AM (CEST GMT+0200)
First name
Broněk
Last name
Dvořák
Mother's maiden name
Vaněk
Gender
Male
Date of Birth
2/25/80
Marital status
Identity Reliability Code

Home

Street address line
Roháče z Dubé
Zip Code
47001
City
Česká Lípa
Country
CZE
Patient Identifiers
  • DDS-72172^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN10241^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
495747ac-ff69-4802-833e-329418abc9e2
Socio-professional occupation
Socio-professional group
Lunar Date
- - 1980
Number of weeks of gestation
SMS Consent
No
Patient history
Visit number
Patient status
Patient class
Last modified date
Action
5/28/21 8:57:09 AM (CEST GMT+0200)