Patient information

ROSE SIMON

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
10/7/21 4:43:34 PM (CEST GMT+0200)
First name
ROSE (ROSE)
Last name
SIMON
Mother's maiden name
Leroy
Gender
Féminin
Date of Birth
5/28/92
Marital status
Identity Reliability Code
Validé

Address

Street address line
Rue Fernand Guillon
Zip Code
17000
City
La Rochelle
Country
FRA

Address

Zip Code
62210
City
Avion
Country
FRA

Birth Delivery Location

INSEE Code
62065
Country
FRA
Patient Identifiers
  • 1698002023710367465343^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54223^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10645^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
Email
Account number
AN1714^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
cce63905-9a12-47af-84b4-ec73faaae8f1
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
  • 2021-10-07 16:43:34.667 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A47^ADT_A30 message
Visit number
Patient status
Patient class
Last modified date
Action