Generated Narrative

status: executed

contentDerivative: Content Registration

issued: 2 Nov. 2013, 12:18:27 pm

applies: 2 Nov. 2013, 12:18:27 pm --> (ongoing)

subject: Generated Summary: BSN: 123456789 (OFFICIAL), BSN: 123456789 (OFFICIAL); active; Roel(OFFICIAL); Phone: +31612345678, Phone: +31201234567; gender: male; birthDate: 1960-03-13; Legally married;

type: Opt-in consent directive

subType: Health Care Directive

term

Offers

-	Type	Decision	Text
*	Statutory	opt-in	Can't refuse

Assets

-	Period
*	2 Nov. 2013, 12:18:27 pm --> 2 Nov. 2019, 12:18:27 pm

action

type: Action A

subject

reference: VA Ann Arbor Healthcare System. Generated Summary: id: 91654 (OFFICIAL), id: 17-0112278 (USUAL); University Medical Hospital; name: Burgers University Medical Center; Phone: 022-655 2300

role: Recipient of restricted health information

subject

reference: Community Mental Health Clinic. Generated Summary: id: 666666; name: XYZ Insurance; alias: ABC Insurance

role: Sender of restricted health information

intent: health program reporting

status: Sample

signer

type: SELF

party: Alice Recruit. Generated Summary: BSN: 123456789 (OFFICIAL), BSN: 123456789 (OFFICIAL); active; Roel(OFFICIAL); Phone: +31612345678, Phone: +31201234567; gender: male; birthDate: 1960-03-13; Legally married;

Signatures

-

*

Legals