Patient information

Thomas Willems

Simulated actor
Patient Identity Source
Last modifier
Anonymous
Last modified date
5/7/19 6:18:16 AM (CEST GMT+0200)
First name
Thomas
Last name
Willems
Mother's maiden name
Peeters
Gender
Male
Date of Birth
2/7/71
Marital status
Identity Reliability Code

Home

Street address line
Molenbaan
Zip Code
2920
City
Kalmthout
Country
BEL
Patient Identifiers
  • 710207 369 53^^^BE&1.3.6.1.4.1.21297.100.1.1&ISO (NH)
  • DDS-65580^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN8894^^^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
- - 1971
Number of weeks of gestation
SMS Consent
No
Patient history
  • 2019-05-07 06:18:18.537 - Patient has been created
  • 2019-05-07 06:18:22.463 - Patient has been sent to SUT (1.3.6.1.4.1.12559.11.1.2.2.5.1 1.3.6.1.4.1.12559.11.1.2.2.5.11) within a PRPA_IN201301UV02 message
Visit number
Patient status
Patient class
Last modified date
Action