Patient information

WILLIAM WALTERS

Simulated actor
Patient Identity Source
Last modifier
Gasper Andrejc
Last modified date
9/8/23 3:42:12 PM (CEST GMT+0200)
First name
WILLIAM
Last name
WALTERS
Gender
Male
Date of Birth
5/4/55
Religion
Shintoist
Marital status
Identity Reliability Code

Home

Street address line
3900 FLORA PL
Zip Code
63110
City
MO
Country
JPN
Patient Identifiers
  • DDS-73984^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN11635^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
41a89c4b-c86f-4321-bbff-63c13e40c247
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1997
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
  • 2023-09-08 15:50:05.736 - Patient has been created by gandrejc_ol
  • 2023-09-08 15:50:07.806 - Patient has been sent to SUT (1.3.6.1.4.1.22390.1337.0.3.1 1.3.6.1.4.1.22390.1337.0.3.1) within a PRPA_IN201301UV02 message by gandrejc_ol
Visit number
Patient status
Patient class
Last modified date
Action