Patient information

ANTOINE BERNARD

Simulated actor
Patient Demographic Supplier
Last modifier
Robin Brech
Last modified date
12/28/23 2:33:07 PM (CET GMT+0100)
First name
ANTOINE (ANTOINE)
Last name
BERNARD
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
6/29/22
Marital status
Identity Reliability Code
Validé

Home

Street address line
Rue Raymond Brau
Zip Code
77290
City
Mitry-Mory
Country
FRA

Birth Delivery Location

Zip Code
28000
City
Chartres
INSEE Code
28085
Country
FRA
Patient Identifiers
  • 11135^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 122062808536451^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 122062808536451^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN2473^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
6cd6bf6c-5d03-4b75-a24c-ce653660aa0b
Socio-professional occupation
Agriculteurs exploitants
Socio-professional group
Ouvriers qualifiés de type artisanal
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 2022
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
  • 2023-12-28 14:33:11.564 - Patient has been created by rbrech
  • 2023-12-28 14:33:12.264 - Patient has been sent to SUT (Cortex-Care Cortex-Care) within a ADT^A28^ADT_A05 message by rbrech
Visit number
Patient status
Patient class
Last modified date
Action