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Document Details
Profile: LACBundleIPSICVP
Final Document at 2025-10-12 11:00:00+0000 by Practitioner Isabel De Obaldía for Gaby Moreno (official) Female, DoB: 1981-12-16 ( National unique individual identifier (use: official, ))
Document Subject
Profile: LACPatient
Gaby Moreno (official) Female, DoB: 1981-12-16 ( Passport number (use: official, ))
| Other Id: | National unique individual identifier/GT098765 (use: official, ) | ||
| Contact Detail | Guatemala | ||
Document Content
Entry 2 - fullUrl = urn:uuid:b2c3d4e5-f6a7-4890-b2c3-d4e5f6a78901
Rec}:
Profile: LACPatient
Gaby Moreno (official) Female, DoB: 1981-12-16 ( Passport number (use: official, ))
Other Id: National unique individual identifier/GT098765 (use: official, ) Contact Detail Guatemala
Entry 3 - fullUrl = urn:uuid:c3d4e5f6-a7b8-4901-c3d4-e5f6a7b89012
Rec}:
Profile: LACOrganization
name: Clínica Hospital San Fernando (ID E7F8)
Contacts
Address Via España, Calle 51 y 52, Ciudad de Panamá
Entry 4 - fullUrl = urn:uuid:e5f6a7b8-c9d0-4123-e5f6-a7b8c9d01234
Rec}:
name: Isabel De Obaldía
Qualifications
Code Doctor of Medicine
Entry 5 - fullUrl = urn:uuid:e5f6a7b8-c9d0-4123-e5f6-a7b8c9d01236
Rec}:
ProductID: WHO PreQualificaiton Vaccine Product Ids: PolioVaccineOralOPVTrivaProductfa4849f7532d522134f4102063af1617 (20/03/2015Polio Vaccine - Oral (OPV) TrivalentBIOPOLIOVial10Bharat Biotech International LimitedCentral Drugs Standard Control Organization)
status: Completed
vaccineCode: Oral poliomyelitis vaccine (OPV)
lotNumber: 123123123
occurrence: 2021-08-09 00:00:00+0000
Performers
Actor Practitioner Isabel De Obaldía protocolApplied
