Patient information

CORENTIN LAURENT

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
10/4/21 4:45:11 PM (CEST GMT+0200)
First name
CORENTIN (CORENTIN)
Last name
LAURENT
Mother's maiden name
Willems
Gender
M
Date of Birth
6/19/52
Marital status
Identity Reliability Code
VIDE

Home

Street address line
Rue des Brasseurs
Zip Code
5000
City
Namur
Country
BEL

Birth Delivery Location

Zip Code
8970
City
Poperinge
INSEE Code
99131
Country
BEL
Patient Identifiers
  • 520619 785 70^^^BE&1.3.6.1.4.1.21297.100.1.1&ISO (NH)
  • DDS-54209^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10636^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
Email
Account number
AN1703^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
c33d60e9-a7a6-4b9c-8ec5-1ab961595d3b
Socio-professional occupation
2
Socio-professional group
38
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1952
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
  • 2021-10-04 16:45:11.928 - Patient has been created by NicolasBailliet
  • 2021-10-04 16:45:12.191 - Patient has been sent to SUT (PAM_FR PatientManager) within a ADT^A47^ADT_A30 message
Visit number
Patient status
Patient class
Last modified date
Action