Patient information

PONS MARTIN

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
8/23/21 10:03:51 AM (CEST GMT+0200)
First name
PONS (PONS)
Last name
MARTIN
Mother's maiden name
Fournier
Gender
Masculin
Date of Birth
12/29/89
Marital status
Identity Reliability Code
Validé

Address

Street address line
Loire à Vélo
Zip Code
45560
City
Saint-Denis-en-Val
Country
FRA

Birth Delivery Location

Zip Code
51200
City
Épernay
INSEE Code
51230
Country
FRA
Patient Identifiers
  • 1324761646576094085190^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54159^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10612^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 189125123025553^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 189125123025553^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1664^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
a49c7933-9034-4589-bb1d-42f30611af3f
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
  • 2021-08-23 10:03:51.24 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A28^ADT_A05 message
  • 2021-08-23 10:03:51.244 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action