Patient information

CHDRSIXTEEN CHDRZZTEST

Simulated actor
Connectathon
Last modifier
matt
Last modified date
12/30/19 5:25:45 PM (CET GMT+0100)
First name
CHDRSIXTEEN
Last name
CHDRZZTEST
Gender
Female
Date of Birth
3/3/76
Marital status
Identity Reliability Code

Home

Street address line
660 16TH STREET
Zip Code
92038
City
La Jolla
State
CA
Country
USA
Patient Identifiers
  • DDS-10^^^&1.3.6.1.4.1.12559.11.40.11&ISO
  • P-000000311^^^IHEPAM&1.3.6.1.4.1.12559.11.20.1&ISO
  • 666000016^^^&2.16.840.1.113883.4.1&ISO
Email
Primary Residence Number
+1-666-00-0016
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
860e5814-7318-419d-8926-31fa48d2782c
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