Patient information

MARIANNE MARTIN

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
8/5/21 4:05:42 PM (CEST GMT+0200)
First name
MARIANNE
Last name
MARTIN
Mother's maiden name
Paquet
Gender
Féminin
Date of Birth
5/8/03
Marital status
Identity Reliability Code

Home

Street address line
Rue des Bordes
Zip Code
33500
City
Libourne
Country
FRA

Home

Zip Code
40100
City
Dax
Country
FRA
Patient Identifiers
  • 10586^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 203054008861557^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 203054008861557^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1636^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
7bb47fcc-6527-4909-894f-b08e5bb33738
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
  • 2021-08-05 16:05:42.688 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A28^ADT_A05 message
  • 2021-08-05 16:05:42.69 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action