Patient information

JEREMIETTE DECOOLETTE

Simulated actor
Patient Demographic Consumer
Last modifier
ELAP GAP_ELAP
Last modified date
10/21/21 2:29:39 PM (CEST GMT+0200)
First name
JEREMIETTE (JEREMIETTE)
Second Name
JEAN
Third Name
JULIEN
Last name
DECOOLETTE
Gender
Masculin
Date of Birth
7/4/77
Marital status
Identity Reliability Code
Validé

Home

Street address line
RUE
Zip Code
84000
City
AVIGNON
Country
FRA

Mailing address

Street address line
RUE
Zip Code
84000
City
AVIGNON
Country
FRA
Patient Identifiers
  • 000000376952^^^ELAP GAP&& (PI)
Email
Primary Residence Number
Primary Residence Number
Primary Residence Number
Primary Residence Number
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
ac82a834-6c83-4ea9-8495-35ec1e4ddadd
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
  • 2021-10-21 14:29:39.706 - Patient has been received from SUT (ELAP ELAP GAP) within a ADT^A31^ADT_A05 message
Visit number
Patient status
Patient class
Last modified date
Action