Patient information

SHAYMA ESSA

Simulated actor
Patient Demographic Supplier
Last modifier
marc quenouillere
Last modified date
10/29/21 4:12:42 PM (CEST GMT+0200)
First name
SHAYMA (SHAYMA)
Last name
ESSA
Mother's maiden name
Bazzi
Gender
Féminin
Date of Birth
12/8/58
Marital status
Identity Reliability Code
Validé

Home

Street address line
Abdulaziz Bin Saleh Street
Zip Code
42311
City
Medina
Country
SAU

Birth Delivery Location

Zip Code
58893
City
Ar Rass
INSEE Code
99201
Country
SAU
Patient Identifiers
  • DDS-54248^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10655^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 258129920161359^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 258129920161359^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1735^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
4812d0fc-6a4b-400b-9eda-377e742665dd
Socio-professional occupation
Employés
Socio-professional group
Anciens artisans, commerçants, chefs d'entreprise
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1958
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
  • 2021-10-29 16:12:48.504 - Patient has been created by mquenouillere
  • 2021-10-29 16:12:49.518 - Patient has been sent to SUT (PAM_FR PatientManager) within a ADT^A28^ADT_A05 message by mquenouillere
Visit number
Patient status
Patient class
Last modified date
Action