Patient information

NICHOLAS GAILLARD

Simulated actor
Patient Demographic Supplier
Last modifier
Anonymous
Last modified date
6/6/24 1:19:24 PM (CEST GMT+0200)
First name
NICHOLAS (NICHOLAS)
Last name
GAILLARD
Mother's maiden name
Michel
Gender
Masculin
Date of Birth
12/11/63
Marital status
Identity Reliability Code
Identité non encore qualifiée

Home

Street address line
103 Rue de Larçay
Zip Code
37550
City
Saint-Avertin
Country
FRA

Birth Delivery Location

Zip Code
49400
City
Saumur
INSEE Code
49328
Country
FRA
Patient Identifiers
  • 1624825080352364976177^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-55001^^^DDS&1.3.6.1.4.1.12559.11.43.9&ISO (PI)
  • 11258^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
Email
Account number
AN2522^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
93090eac-02a8-4bf3-b6c7-1d22f9eace7c
Socio-professional occupation
Autres personnes sans activité professionnelle
Socio-professional group
Personnes diverses sans activité professionnelle de moins de 60 ans (sauf retraités)
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1963
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
  • 2024-06-06 13:19:24.148 - Patient has been created by mhajjam
  • 2024-06-06 13:19:25.043 - Patient has been sent to SUT (MyPredi MyPredi) within a ADT^A47^ADT_A30 message
  • 2024-06-15 17:18:37.132 - Patient has been sent to SUT (MyPredi MyPredi) within a ADT^A28^ADT_A05 message
  • 2024-06-18 17:27:00.079 - Patient has been sent to SUT (Ecare Ecare) within a ADT^A28^ADT_A05 message
Visit number
Patient status
Patient class
Last modified date
Action