Patient information

BLAZENA TUREK

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
10/4/21 11:18:31 AM (CEST GMT+0200)
First name
BLAZENA (BLAZENA)
Last name
TUREK
Mother's maiden name
Hošek
Gender
Féminin
Date of Birth
6/2/41
Marital status
Identity Reliability Code
Validé

Address

Street address line
Frýdlantská
Zip Code
46059
City
Liberec
Country
CZE

Address

Zip Code
43201
City
Kada?
Country
CZE

Birth Delivery Location

INSEE Code
99116
Country
CZE
Patient Identifiers
  • DDS-54206^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10634^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 241069911673820^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 241069911673820^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
nom.patient@test.fr
Account number
AN1701^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
b58161ad-f5a4-47af-8099-9752ece724af
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
4
SMS Consent
Yes
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 11:18:31.991 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A28^ADT_A05 message
  • 2021-10-04 11:18:31.994 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action