Patient information

Clare Jackson

Simulated actor
Connectathon
Last modifier
sryan
Last modified date
2/23/21 12:47:56 PM (GMT GMT+0000)
First name
Clare
Last name
Jackson
Gender
Female
Date of Birth
4/1/80
Marital status
Identity Reliability Code

Home

Street address line
4 Main Street, Sicktown
Zip Code
D02 H687
City
Dublin
State
Co. Dublin
Country
IRL
Patient Identifiers
  • 1234-512-345-123-45004^^^&1.2.372.980010.1.2&ISO
  • 8888884A^^^&1.2.372.980010.1.2&ISO
Email
Account number
GZLAN31^^^GZL&1.3.6.1.4.1.12559.11.35.8.1&ISO^AN
Blood group
VIP Indicator
Birth Place Name
UUID
d7f1060e-c762-4cd5-abd6-e0585734e466
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- - 1976
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
Visit number
Patient status
Patient class
Last modified date
Action