Patient information

BENJAMIN MARTIN

Simulated actor
Patient Demographic Supplier
Last modifier
Clotaire Delanchy
Last modified date
3/13/24 3:36:17 PM (CET GMT+0100)
First name
BENJAMIN (BENJAMIN)
Last name
MARTIN
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
9/25/52
Marital status
Identity Reliability Code
Identité non encore qualifiée

Home

Street address line
Avenue Jean Giono
Zip Code
13190
City
Allauch
Country
FRA

Birth Delivery Location

Zip Code
59200
City
Tourcoing
INSEE Code
59599
Country
FRA
Patient Identifiers
  • 0109413721360988775654^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-55045^^^DDS&1.3.6.1.4.1.12559.11.36.3&ISO (PI)
  • 11154^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
Email
Account number
AN2501^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
353bbb3d-427f-4aae-8ca2-4b3a5d8598a5
Socio-professional occupation
Artisans, commerçants et chefs d'entreprise
Socio-professional group
Anciens artisans, commerçants, chefs d'entreprise
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
  • 2024-03-13 15:36:35.308 - Patient has been created by cdelanchy
  • 2024-03-13 15:36:36.193 - Patient has been sent to SUT (PAM_FR PatientManager) within a ADT^A31^ADT_A05 message by cdelanchy
Visit number
Patient status
Patient class
Last modified date
Action