Patient information

PATRICE BERNARD

Simulated actor
Patient Demographic Supplier
Last modifier
tech.tilak
Last modified date
6/12/24 10:12:10 AM (CEST GMT+0200)
First name
PATRICE (PATRICE)
Last name
BERNARD
Mother's maiden name
Martin
Gender
Masculin
Date of Birth
12/21/84
Marital status
Identity Reliability Code
Validé

Home

Street address line
Rue de la Paix
Zip Code
53000
City
Laval
Country
FRA

Birth Delivery Location

Zip Code
83700
City
Saint-Raphaël
INSEE Code
24493
Country
FRA
Patient Identifiers
  • 1726731681727355730387^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-55007^^^DDS&1.3.6.1.4.1.12559.11.43.9&ISO (PI)
  • 11263^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 184122449380358^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 184122449380358^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN2528^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
4a337043-612c-4792-aedd-f881688c6c78
Socio-professional occupation
Professions Intermédiaires
Socio-professional group
Clergé, religieux
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1984
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
  • 2024-06-12 10:23:29.014 - Patient has been created by tech.tilak
  • 2024-06-12 10:23:29.301 - Patient has been sent to SUT (Tilak Test Python decoder) within a ADT^A28^ADT_A05 message by tech.tilak
Visit number
Patient status
Patient class
Last modified date
Action