Patient information

SEVERINE MARTIN

Simulated actor
Patient Demographic Supplier
Last modifier
tech.tilak
Last modified date
6/12/24 10:34:29 AM (CEST GMT+0200)
First name
SEVERINE (SEVERINE)
Last name
MARTIN
Mother's maiden name
Martin
Gender
Féminin
Date of Birth
8/2/96
Marital status
Identity Reliability Code
Validé

Home

Street address line
Rue Aristide Briand
Zip Code
94340
City
Joinville-le-Pont
Country
FRA

Birth Delivery Location

Zip Code
76130
City
Mont-Saint-Aignan
INSEE Code
76451
Country
FRA
Patient Identifiers
  • 1608752648769887945231^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-55008^^^DDS&1.3.6.1.4.1.12559.11.43.9&ISO (PI)
  • 11264^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 296087645174744^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 296087645174744^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN2529^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
ecd2ffb7-351d-45e6-8fbc-4a1d6a874ee5
Socio-professional occupation
Agriculteurs exploitants
Socio-professional group
Chauffeurs
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1996
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 10:34:43.298 - Patient has been created by tech.tilak
  • 2024-06-12 10:34:43.493 - Patient has been sent to SUT (Tilak Test Python decoder) within a ADT^A28^ADT_A05 message by tech.tilak
  • 2024-06-12 12:39:11.779 - 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