Patient information

MODESTE LOPEZ

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
2/24/22 11:21:35 AM (CET GMT+0100)
First name
MODESTE (MODESTE)
Last name
LOPEZ
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
4/3/16
Marital status
Identity Reliability Code
Validé

Home

Street address line
Chemin de Condren à Fargnier
Country
FRA

Birth Delivery Location

Zip Code
91270
City
Vigneux-sur-Seine
INSEE Code
91657
Country
FRA
Patient Identifiers
  • DDS-54356^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10721^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 116049165785867^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 116049165785867^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1840^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
2cfd8556-c32f-45d4-8dc2-67de8d4cc42e
Socio-professional occupation
Agriculteurs exploitants
Socio-professional group
Artisans
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 2016
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
  • 2022-02-24 11:22:19.269 - Patient has been created
  • 2022-02-24 11:22:20.132 - Patient has been sent to SUT (PAM_FR PatientManager) within a ADT^A28^ADT_A05 message
  • 2022-03-21 11:00:23.975 - Patient has been sent to SUT (KALISIL KALISIL) within a ADT^A28^ADT_A05 message
Visit number
Patient status
Patient class
Last modified date
Action