Patient information

CORENTIN LAURENT

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
10/4/21 4:45:12 PM (CEST GMT+0200)
First name
CORENTIN (CORENTIN)
Last name
LAURENT
Mother's maiden name
Willems
Gender
Masculin
Date of Birth
6/19/52
Marital status
Identity Reliability Code
Validé

Address

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

Address

Zip Code
8970
City
Poperinge
Country
BEL

Birth Delivery Location

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
dc44ce91-93b9-4e77-a5c4-7eba7fad6d4e
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
  • 2021-10-04 16:45:12.106 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A47^ADT_A30 message
Visit number
Patient status
Patient class
Last modified date
Action