Patient information

Simon Adam

Simulated actor
Patient Demographic Supplier
Last modifier
Henri Cazottes
Last modified date
9/26/23 10:08:43 AM (CEST GMT+0200)
First name
Simon
Last name
Adam
Mother's maiden name
Janssens
Gender
Male
Date of Birth
11/26/71
Marital status
Identity Reliability Code

Home

Street address line
de Merodedreef
Zip Code
2260
City
Westerlo
Country
BEL
Patient Identifiers
  • 711126 265 38^^^BE&1.3.6.1.4.1.21297.100.1.1&ISO (NH)
  • DDS-74189^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN11794^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
5f99151a-740e-40b7-9ed5-17745720022f
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1971
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
  • 2023-09-26 10:08:46.232 - Patient has been created by hcazottes
  • 2023-09-26 10:08:46.315 - Patient has been sent to SUT (OTHER_Lifen_Platform Lifen) within a ADT^A28^ADT_A05 message by hcazottes
Visit number
Patient status
Patient class
Last modified date
Action