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ID Image

Max Mustermann

11 Dec 1985

Last update: 14 Jun 2018 13:18

Attention!


This person
  • has the following disease(s):
    • Autoimmune thrombocytopenic purpura (Idiopathic thrombocytopenic purpura) (D69.3)
    • La Tourette Syndrom (La Tourette Syndrom) (F95.2)
    • Hemophilia A (Hereditary factor VIII deficiency) (D66)
  • has the following allergies(s):
    • Bee
  • is an organ donor
  • has an Advance directive (see "Documents")

Information


All data shown on this page has been provided by the patient.

Patient Details

Title M.

First name Max

Last name Mustermann

Birth date 11 Dec 1985

Primary Language Luxembourgeois (Luxembourgish)

Contact Details

Address 3, rue de l'ascenseur L-1234 Kirchberg Luxembourg View on Map

Home Telephone 00352 12 34 56 78

Work Telephone 00352 87 65 43 21

Cell Telephone 00352 621 12 34 56

Fax Number 00352 12 34 56 78

E-Mail pierre@example.com

Insurance Details

Social Security Number / National Insurance Number 19630508123

Insurance Carrier Caisse de Santé Luxembourg

Additional Insurance CMCM A-1234567

Medical Details

Weight 72.3 kg

Size 1.85 m

BMI 21.04

Bloodgroup A Rh+

Organ Donor Yes

Gender Male

Blood transfusions allowed Yes

Idiopathic thrombocytopenic purpura ICD-10: D69.3

Disease details

Popular Term Autoimmune thrombocytopenic purpura

Active Yes

Disease type Chronical

La Tourette Syndrom ICD-10: F95.2

Disease details

Popular Term La Tourette Syndrom

Active Yes

Disease type Acute

Disease onset December 2012

Treatment details

Treatment ukfk

Hereditary factor VIII deficiency ICD-10: D66

Disease details

Popular Term Hemophilia A

Active Yes

Disease type Chronical

Disease onset May 1963

Disease diagnosed May 1963

Liver transplant

Surgery details

Surgery date 19 Feb 2008

Attached physician Prof. Dr. med. Jèmal Partou For more information about the physician, see the "Physicians" section.

Simvastatin 40mg

Medication details

Active substance Simvastatin 40mg

Kogenate

Medication details

Manufacturer Bayer

Active substance Octocog Alpha, blood coagulation Factor VIII

Dosage details

Dosage: 3 * 1000 IU / Semaine

Attached physician Prof. Dr. med. Jèmal Partou For more information about the physician, see the "Physicians" section.

Bee

Allergy details

Active Yes

Reactions

  • Hives
  • Itching
  • Diarrhea
Treatment details

Attached physician Prof. Dr. med. Jèmal Partou For more information about the physician, see the "Physicians" section.

Meningitis

Vaccination details

Last Vaccination 05 Feb 2015

Hepatitis B

Vaccination details

Last Vaccination 18 Nov 2015

Hepatitis A

Vaccination details

Last Vaccination 13 Nov 2015

Jules Dupond (Father)

Personal information

Title Mr.

First name Jules

Last name Dupond

Relationship Father

Contact Details

Address 4, rue de l'ascenseur 1234 Kirchberg Luxembourg View on Map

Home Telephone 00352 12 34 56 78

Work Telephone 00352 87 65 43 21

Cell Telephone 00352 621 12 34 56

E-Mail jules.dupond@example.com

Simone Dupond (Mother)

Personal information

Title Mme.

First name Simone

Last name Dupond

Relationship Mother

Contact Details

Address 4, rue de l'ascenseur 1234 Kirchberg Luxembourg View on Map

Home Telephone 00352 12 34 56 78

Work Telephone 00352 87 65 43 21

Cell Telephone 00352 621 12 34 56

Prof. Dr. med. Jèmal Partou

Physician details

Title Prof. Dr. med.

First name Jèmal

Last name Partou

Company/Hospital Hôpital Répartou

Contact Details

Address 9, rue du Pied crevé L-9876 Paris France View on Map

Address Type Hospital

Home Telephone 456789123

Work Telephone 654987321

Cell Telephone 159753456

E-Mail jemal.partou@example.com

ID Image

Document details

Document name ID Image

Passport

Document details

Document name Passport

Document type Passport

Advance Directive

Document details

Document name Advance Directive

Document type Advance directive

Organ donor

Document details

Document name Organ donor