Patient information

QTF TEST QTFTEST-001

Simulated actor
Patient Demographic Consumer
Last modifier
Anonymous
Last modified date
7/3/23 4:59:46 AM (EDT GMT-0400)
First name
QTF TEST
Last name
QTFTEST-001 (Blanda868)
Gender
Female
Date of Birth
9/18/58
Marital status
Identity Reliability Code

Home

Street address line
577 Schmeler Frontage road Unit 7
City
Quincy
State
MA
Country
USA
Patient Identifiers
  • PID-COMMUNITY1-QTFTEST-001^^^&1.3.6.1.4.1.21367.13.20.2000 (PI)
Email
Primary Residence Number
tel:tel:+1-617-555-1111
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
ee7b3ed6-2ff0-4c87-8d92-d9651ab52532
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- -
Date de naissance corrigé
No
Mode d'obtention de l'identité
Justificatif d'identité
Valide jusqu'au
Date d'interrogation du téléservice INSi
Patient history
Visit number
Patient status
Patient class
Last modified date
Action