Patient information

Michael's Martinson's

Simulated actor
Patient Identity Source
Last modifier
meenal
Last modified date
5/17/19 9:57:57 AM (CEST GMT+0200)
First name
Michael's
Last name
Martinson's
Mother's maiden name
Alfonso
Gender
Male
Date of Birth
8/22/18
Religion
Christian: Roman Catholic
Race
White
Marital status
Identity Reliability Code

Home

Street address line
Katella Avenue
Zip Code
90680
City
Stanton
State
California
Country
USA
Patient Identifiers
  • DDS-65639^^^DDS&1.3.6.1.4.1.12559.11.1.4.1.2&ISO (PI)
Email
Account number
AN8920^^^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
- - 2018
Number of weeks of gestation
SMS Consent
No
Patient history
  • 2019-05-17 10:01:38.376 - Patient has been created by meenal
  • 2019-05-17 10:01:42.785 - 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 by meenal
Visit number
Patient status
Patient class
Last modified date
Action