Patient information

Chdrfive Chdrzzztest

Simulated actor
Connectathon
Last modifier
matt
Last modified date
12/30/19 5:25:45 PM (CET GMT+0100)
First name
Chdrfive
Last name
Chdrzzztest
Gender
Male
Date of Birth
3/3/65
Marital status
Identity Reliability Code

Home

Street address line
660 5th St
Zip Code
92038
City
LA JOLLA
State
CA

Home

Patient Identifiers
  • 666000005^^^&2.16.840.1.113883.4.1&ISO
  • E6006142^^^&2.16.840.1.113883.3.579.1.10&ISO
  • 5ZXFFNIRRLNETBEA5KO6CIUIIQ^^^&2.16.840.1.113883.3.579.1.10&ISO
  • 666000005^^^&2.16.840.1.113883.3.579.1.10&ISO
  • E6006142^^^&2.16.840.1.113883.4.305.1.157&ISO
Email
Work Number
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
e3407a48-c8bd-41e0-ae5b-6e1b210988a1
Socio-professional occupation
Socio-professional group
Lunar Date
- -
Number of weeks of gestation
SMS Consent
No
Patient history
Visit number
Patient status
Patient class
Last modified date
Action