Patient information

JULIEN RIVAL

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
1/7/22 11:59:39 AM (CET GMT+0100)
First name
JULIEN (JULIEN)
Last name
RIVAL
Mother's maiden name
Martin
Gender
M
Date of Birth
5/29/50
Marital status
Identity Reliability Code
VALI

Home

Street address line
Rue du Stand
Zip Code
25300
City
Pontarlier
Country
FRA

Birth Delivery Location

Zip Code
33700
City
Mérignac
INSEE Code
33281
Country
FRA
Patient Identifiers
  • 0422612378308876980005^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54338^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10714^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 150053328157305^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 150053328157305^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1823^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
b64a9e55-2a64-4210-b608-72ae117d4300
Socio-professional occupation
4
Socio-professional group
43
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1950
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
  • 2022-01-07 12:00:18.662 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action