Patient information

CHARLES SIMON

Simulated actor
Patient Demographic Supplier
Last modifier
Rudy Delepine
Last modified date
4/7/22 4:05:11 PM (CEST GMT+0200)
First name
CHARLES (CHARLES)
Last name
SIMON
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
11/13/55
Marital status
Identity Reliability Code
Validé

Home

Street address line
Chemin des Praillons
Zip Code
77350
City
Le Mée-sur-Seine
Country
FRA

Birth Delivery Location

Zip Code
27400
City
Louviers
INSEE Code
27375
Country
FRA
Patient Identifiers
  • 0139546264887625321624^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-54379^^^DDS&1.3.6.1.4.1.12559.11.36.9&ISO (PI)
  • 10731^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 155112737507425^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 155112737507425^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN1860^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
d65ad160-a5a0-4a74-ba6a-b8ec79cecec6
Socio-professional occupation
Employés
Socio-professional group
Ouvriers qualifiés de type artisanal
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1955
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
  • 2022-04-07 16:05:33.965 - Patient has been created by rudy.delepine
  • 2022-04-07 16:05:36.376 - Patient has been sent to SUT (v3from219 OGiRYS) within a ADT^A28^ADT_A05 message by rudy.delepine
Visit number
Patient status
Patient class
Last modified date
Action