Patient information

匠 松本

Simulated actor
Patient Demographic Supplier
Last modifier
m.dellaquila
Last modified date
4/4/19 3:43:00 PM (CEST GMT+0200)
First name
Last name
松本
Mother's maiden name
田中
Gender
Female
Date of Birth
8/22/88
Religion
Shintoist
Marital status
Identity Reliability Code

Home

Street address line
Ibaraki-Iwama Line
Zip Code
311-3116
City
Ibaraki
Country
JPN
Patient Identifiers
  • DDS-65109^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
  • 5424^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO (PI)
  • IHEBLUE-2925^^^IHEBLUE&1.3.6.1.4.1.21367.13.20.3000&ISO (PI)
  • IHEFACILITY-2925^^^IHEFACILITY&1.3.6.1.4.1.21367.3000.1.6&ISO (PI)
  • IHEGREEN-2925^^^IHEGREEN&1.3.6.1.4.1.21367.13.20.2000&ISO (PI)
  • IHERED-2925^^^IHERED&1.3.6.1.4.1.21367.13.20.1000&ISO (PI)
Email
Account number
AN8653^^^IHEPAM&1.3.6.1.4.1.12559.11.1.2.2.5&ISO^AN
Blood group
VIP Indicator
Birth Place Name
Socio-professional occupation
Socio-professional group
Lunar Date
- - 1988
Number of weeks of gestation
SMS Consent
No
Patient history
  • 2019-04-04 15:43:41.42 - Patient has been created by m.dellaquila
Visit number
Patient status
Patient class
Last modified date
Action