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• Provided by the local registry system.  
• Should be worldwide unique.
  • Should follow the construct of hub code + local patient id. 
    • The hub code should be the two-character ISO country code of the registry (e.g. DE for Germany)  
      • In the case of multiple registries in one country, a replacement code will be assigned.
• Should be provided as a user-friendly (displayable) id for use on screens and on documentation.

TODO:  Discuss whether patientId should be made required within createPatientRequest and updatePatientRequest

Risk of nullable is that duplicate patients may be created.  Some transplant centers or patient registries may have concerns with sharing a patientId before the point of donor request.  If we make patientId required then we should also consider enforcing uniqueness.  Decision on nullability deferred to the business requirements group.

• Generated by the central (SMC) system.
• Must be unique.
• Must be used for all system-to-system patient identification after the initial patient registration.
• Should be displayed on screens and on documentation.