Patient information

MATHILDE MARTIN

Simulated actor
Patient Demographic Supplier
Last modifier
tech.tilak
Last modified date
6/11/24 2:12:34 PM (CEST GMT+0200)
First name
MATHILDE (MATHILDE)
Last name
MARTIN
Mother's maiden name
Bernard
Gender
Féminin
Date of Birth
8/7/97
Marital status
Identity Reliability Code
Validé

Home

Street address line
Place Jean Guéhenno
Zip Code
35300
City
Fougères
Country
FRA

Birth Delivery Location

Zip Code
13600
City
La Ciotat
INSEE Code
13028
Country
FRA
Patient Identifiers
  • 0321388115088297548764^^^ASIP-SANTE-INS-C&1.2.250.1.213.1.4.6&ISO (NH)
  • DDS-55003^^^DDS&1.3.6.1.4.1.12559.11.43.9&ISO (PI)
  • 11259^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO (PI)
  • 297081302825537^^^ASIP-SANTE-INS-NIR&1.2.250.1.213.1.4.10&ISO (INS)
  • 297081302825537^^^ASIP-SANTE-INS-NIA&1.2.250.1.213.1.4.9&ISO (INS)
Email
Account number
AN2524^^^GZL_INTEROP&2.16.840.1.113883.2.8.3.7&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
25446b35-d0b7-42b7-b9d1-264c45714e20
Socio-professional occupation
Cadres et professions intellectuelles supérieures
Socio-professional group
Professions de l'information, des arts et des spectacles
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- 0 - 1997
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
  • 2024-06-11 14:12:54.858 - Patient has been created by tech.tilak
  • 2024-06-11 14:12:55.061 - 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