Patient information

ALISSA MOHRA

Simulated actor
Connectathon
Last modifier
Anonymous
Last modified date
10/15/24 2:20:50 PM (CEST GMT+0200)
First name
ALISSA
Last name
MOHRA
Gender
Female
Date of Birth
1/30/58
Marital status
Identity Reliability Code

Home

Street address line
820 JORIE BLVD.
Zip Code
60523
City
OAK BROOK
State
IL
Country
USA
Patient Identifiers
  • IHERED-994^^^&1.3.6.1.4.1.21367.13.20.1000&ISO (ISO)
Email
Account number
Blood group
VIP Indicator
Birth Place Name
UUID
PatientPIXmFeed
Socio-professional occupation
Socio-professional group
Number of weeks of gestation
SMS Consent
No
Date de naissance carte Vitale
- -
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