Patient information

Pam Zzztestpat

Simulated actor
Connectathon
Last modifier
tnylander
Last modified date
7/28/20 8:24:07 PM (EDT GMT-0400)
Warning: this patient is no more active and cannot be updated anymore
First name
Pam
Last name
Zzztestpat
Gender
Female
Date of Birth
8/28/28
Marital status
Identity Reliability Code

Home

Street address line
137 ELM STREET
Zip Code
32129
City
Port Orange
State
FL
Country
USA
Patient Identifiers
  • DDS-CATT-54724^^^DDS-CATT&1.3.6.1.4.1.12559.11.24.4.9&ISO (PI)
  • 777-77-0212^^^&2.16.840.1.113883.4.1&ISO (PI)
  • P-000000315^^^IHEPAM&1.3.6.1.4.1.12559.11.20.1&ISO (PI)
  • 100249450^^^&2.16.840.1.113883.3.4234.2&ISO
Email
Primary Residence Number
+1-608-555-1211
Account number
AN200^^^IHEPAM&1.3.6.1.4.1.12559.11.20.1&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
8325f7a9-ca16-46b6-85ea-b172d10b3d57
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