Patient information

Carson Robert

Simulated actor
Patient Demographic Consumer
Last modifier
pescarcega
Last modified date
4/13/20 8:28:38 PM (CEST GMT+0200)
First name
Carson
Second Name
M
Last name
Robert
Gender
Male
Date of Birth
2/10/60
Marital status
Identity Reliability Code

Home

Street address line
290 Jackson Lane
City
Boulder
State
CO
Patient Identifiers
  • 1000053003^^^&2.16.840.1.113883.3.1108 (PI)
Email
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
8872a512-176e-4084-b7a6-bdca637d9062
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