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'88959b2c541a8854042ef52b45af1075' => {
                                        'files' => [
...
                                        'dme_pid' => '938edfd95dd42a58
+786330bb8c85f479',
                                        'first_name' => 'John'
                                      },

foreach my $key (sort { $patients->{$a}->{old_file} cmp $patients->{$b
+}->{old_file} }
   (keys %{$patients})) {
      # print ...
}