Patient information

LAZARE BENARD

Simulated actor
Patient Demographic Consumer
Last modifier
Gazelle_PAM_FR
Last modified date
12/9/22 2:42:41 PM (CET GMT+0100)
First name
LAZARE (LAZARE)
Last name
BENARD
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
10/17/07
Marital status
Identity Reliability Code
Validé

Home

Street address line
Rue des Adouberies
Zip Code
47200
City
Marmande
Country
FRA

Birth Delivery Location

Zip Code
49051
City
Angers
INSEE Code
49007
Country
FRA
Patient Identifiers
  • 0364853110572247021456^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54258^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10659^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 107104900746597^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 107104900746597^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1745^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
4f97745a-b591-4b83-8e31-38c287e55496
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
  • 2022-12-09 14:42:41.882 - Patient has been received from SUT (PAM_FR Gazelle) within a ADT^A28^ADT_A05 message
  • 2022-12-09 14:42:41.885 - Patient has been created
Visit number
Patient status
Patient class
Last modified date
Action