This page is part of the Vital Records Birth and Fetal Death Reporting (v0.1.0: STU 1 on FHIR R4 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions 
| Identifier | 1032702 |
| Address |
1875 West Morton Avenue
Salt Lake City UT US |
| Date of birth | 24 November 1974 |