Patient information

QTF TEST QTFTEST-003

Simulated actor
Connectathon
Last modifier
mtoudic
Last modified date
11/8/22 4:21:19 PM (EST GMT-0500)
First name
QTF TEST
Last name
QTFTEST-003
Gender
Female
Date of Birth
4/2/73
Race
Asian
Marital status
Single
Identity Reliability Code

Home

Street address line
239 Upton Walk
Zip Code
01852
City
Lowell
State
MA
Country
USA

Birth Delivery Location

City
Hanoi
State
Hà Đông
Country
VNM
Patient Identifiers
  • PID-COMMUNITY1-QTFTEST-003^^^&1.3.6.1.4.1.21367.13.20.2000&ISO (PI)
Email
Primary Residence Number
tel:+1-508-555-3333
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
402f96d6-a41a-4774-ac83-9977f04c52f6
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1977
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