Patient information

EHEALTHMARK EHEALTH

Simulated actor
Connectathon
Last modifier
matt
Last modified date
12/30/19 5:25:45 PM (EST GMT-0500)
Warning: this patient is no more active and cannot be updated anymore
First name
EHEALTHMARK
Last name
EHEALTH
Gender
Male
Date of Birth
3/2/83
Marital status
Identity Reliability Code

Home

Street address line
333 TEST STREET
Zip Code
34683
City
PALM HARBOR
State
FL
Country
USA
Patient Identifiers
  • 666100051^^^&2.16.840.1.113883.4.1&ISO
  • 3154109^^^&2.16.840.1.113883.3.7204.1.3.2.1&ISO
Email
Primary Residence Number
+1-333-222-1212
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
61263415-9be1-4bd8-9bf0-a340659ae7e2
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