Patient information

ADELAIDE PETIT

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
10/12/21 3:37:44 PM (CEST GMT+0200)
First name
ADELAIDE (ADELAIDE)
Last name
PETIT
Mother's maiden name
Gerard
Gender
Féminin
Date of Birth
2/13/16
Marital status
Identity Reliability Code
Validé

Address

Street address line
Impasse du Soleil Levant
Zip Code
13140
City
Miramas
Country
FRA

Address

Zip Code
92270
City
Bois-Colombes
Country
FRA

Birth Delivery Location

INSEE Code
92009
Country
FRA
Patient Identifiers
  • 1434129380796424337074^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54228^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10647^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 216029200930764^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 216029200930764^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1718^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
452fe49d-4a49-4597-b57d-b44bbc700d65
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
  • 2021-10-12 15:37:44.264 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A28^ADT_A05 message
  • 2021-10-12 15:37:44.267 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action