Patient information

JEROME SIMON

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
11/1/21 1:31:22 PM (CET GMT+0100)
First name
JEROME (JEROME)
Last name
SIMON
Mother's maiden name
Lefebvre
Gender
M
Date of Birth
3/14/72
Marital status
Identity Reliability Code
VALI

Home

Street address line
Cours Gambetta
Zip Code
69007
City
Lyon
Country
FRA

Birth Delivery Location

Zip Code
77500
City
Chelles
INSEE Code
60145
Country
FRA
Patient Identifiers
  • 0061476348908503631342^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54256^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10658^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 172036014503271^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 172036014503271^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1743^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
b7bc012d-53b0-482f-922d-b8e1b4c698e7
Socio-professional occupation
8
Socio-professional group
77
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1972
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
  • 2021-11-01 13:32:03.8 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action