NameDescriptionTypeAdditional information
LastName

Last Name

string

Max length: 255
FirstName

First Name

string

Max length: 255
MiddleName

Middle Name

string

Max length: 255
Relationship

Relationship to Patient

    Code [Description]
  • GRD [Guardian]
  • PAR [Parent]
  • MTH [Mother]
  • FTH [Father]
  • GRP [GrandParent]
  • SPO [Spouse]
  • DOM [Life Partner]
  • SIB [Sibling]
  • BRO [Brother]
  • SIS [Sister]
  • OTH [Other]
  • UNK [Unknown]

 string

Max length: 25
Address1

Address line 1

string

Max length: 255
Address2

Address line 2

string

Max length: 255
City

City

string

Max length: 255
State

State or Province

string

Max length: 255
ZipCode

Zip or postal code

string

Max length: 10
Phone

Main Phone

string

Max length: 25