@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

# 
# Title:        Referral Note
# Based on:     C-CDA_R2_Referral_Note.xml
#
# Updated for C-CDA R3.0 with a focus on header elements
#  - required/suggested sections are populated with nullFlavor="NI"
#	  to demonstrate WHICH sections should be included, but they
#		all contain "No information" as this is an example of the header
#  
# ********************************************************
# Disclaimer: This sample file contains representative data elements to represent a Referral Note. 
# The file depicts a fictional character's health data. Any resemblance to a real person is coincidental. 
# To illustrate as many data elements as possible, the clinical scenario may not be plausible. 
# The data in this sample file is not intended to represent real patients, people or clinical events. 
# This sample is designed to be used in conjunction with the C-CDA Clinical Notes Implementation Guide.
# ********************************************************
# 

[a fhir:ClinicalDocument ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:realmCode ( [
     fhir:code [ fhir:v "US" ]
  ] ) ; #  ** CDA Header ** 
  fhir:typeId [
     fhir:extension [ fhir:v "POCD_HD000040" ] ;
     fhir:root [ fhir:v "2.16.840.1.113883.1.3" ]
  ] ; # 
  fhir:templateId ( [
     fhir:extension [ fhir:v "2024-05-01" ] ;
     fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.1.1" ]
  ] [
     fhir:extension [ fhir:v "2024-05-01" ] ;
     fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.1.14" ]
  ] ) ; #  Identifies document as conformant to US Realm Header (V2) Template 
  fhir:id [
     fhir:root [ fhir:v "6f1bd58b-c58f-40b7-b314-caf1294ed98b" ]
  ] ; #  DocumentID: unique ID for the document 
  fhir:sdtcCategory ( [
     fhir:code [ fhir:v "57133-1" ] ;
     fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
     fhir:displayName [ fhir:v "Referral note" ]
  ] ) ; # 
  fhir:code [
     fhir:code [ fhir:v "57133-1" ] ;
     fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
     fhir:codeSystemName [ fhir:v "LOINC" ] ;
     fhir:displayName [ fhir:v "Referral Note" ]
  ] ; #  Referral Note 
  fhir:title [
     fhir:xmlText [ fhir:v "Referral Note" ]
  ] ; #  Use the name of the code as the title 
  fhir:effectiveTime [
     fhir:value [ fhir:v "2013-09-21T05:00:00-08:00"^^xsd:dateTime ]
  ] ; # 
  fhir:confidentialityCode [
     fhir:code [ fhir:v "N" ] ;
     fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.25" ]
  ] ; # 
  fhir:languageCode [
     fhir:code [ fhir:v "en" ]
  ] ; # 
  fhir:setId [
     fhir:extension [ fhir:v "sTT988" ] ;
     fhir:root [ fhir:v "2.16.840.1.113883.19.5.99999.19" ]
  ] ; # 
  fhir:versionNumber [
     fhir:value [ fhir:v 1 ]
  ] ; # 
  fhir:recordTarget ( [
     fhir:patientRole [
       fhir:id ( [
         fhir:extension [ fhir:v "444222222" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.1" ]
       ] ) ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "HP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "2222 Home Street" ]
           ] #  HP is \"primary home\" from codeSystem 2.16.840.1.113883.5.1119 
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Beaverton" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "97867" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ; #  Example Social Security Number using the actual SSN OID. ,  US is \"United States\" from ISO 3166-1 Country Codes: 1.0.3166.1 
       fhir:telecom ( [
         fhir:use ( [ fhir:v "HP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)555-2003"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)555-2003
         ]
       ] ) ;
       fhir:patient [
         fhir:name ( [
           fhir:use ( [ fhir:v "L" ] ) ;
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Eve" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Betterhalf" ] ;
               fhir:qualifier ( [ fhir:v "SP" ] )
             ] ) #  The \"SP\" is \"Spouse\" from HL7 Code System EntityNamePartQualifier 2.16.840.1.113883.5.43 
           ] )
         ] [
           fhir:use ( [ fhir:v "SRCH" ] ) ;
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Eve" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Everywoman" ] ;
               fhir:qualifier ( [ fhir:v "BR" ] )
             ] ) #  The \"BR\" is \"Birth\" from HL7 Code System EntityNamePartQualifier 2.16.840.1.113883.5.43 
           ] )
         ] ) ; #  The first name element represents what the patient is known as 
         fhir:administrativeGenderCode [
           fhir:code [ fhir:v "F" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.1" ] ;
           fhir:codeSystemName [ fhir:v "AdministrativeGender" ] ;
           fhir:displayName [ fhir:v "Female" ]
         ] ;
         fhir:birthTime [
           fhir:value [ fhir:v "1975-05-01"^^xsd:date ]
         ] ; #  Date of birth need only be precise to the day 
         fhir:maritalStatusCode [
           fhir:code [ fhir:v "M" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.2" ] ;
           fhir:codeSystemName [ fhir:v "MaritalStatusCode" ] ;
           fhir:displayName [ fhir:v "Married" ]
         ] ;
         fhir:religiousAffiliationCode [
           fhir:code [ fhir:v "1013" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.1076" ] ;
           fhir:codeSystemName [ fhir:v "HL7 Religious Affiliation" ] ;
           fhir:displayName [ fhir:v "Christian (non-Catholic, non-specific)" ]
         ] ;
         fhir:raceCode [
           fhir:code [ fhir:v "2106-3" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
           fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
           fhir:displayName [ fhir:v "White" ]
         ] ; #  CDC Race and Ethnicity code set contains the five minimum race and ethnicity \n					categories defined by OMB Standards 
         fhir:sdtcRaceCode ( [
           fhir:code [ fhir:v "2076-8" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
           fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
           fhir:displayName [ fhir:v "Native Hawaiian or Other Pacific Islander" ]
         ] ) ; #  The raceCode extension is only used if raceCode is valued 
         fhir:ethnicGroupCode [
           fhir:code [ fhir:v "2186-5" ] ;
           fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
           fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
           fhir:displayName [ fhir:v "Not Hispanic or Latino" ]
         ] ;
         fhir:guardian ( [
           fhir:code [
             fhir:code [ fhir:v "POWATT" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.111" ] ;
             fhir:codeSystemName [ fhir:v "RoleCode" ] ;
             fhir:displayName [ fhir:v "Power of Attorney" ]
           ] ;
           fhir:addr ( [
             fhir:use ( [ fhir:v "HP" ] ) ;
             fhir:item ( [
               fhir:streetAddressLine [
                 fhir:xmlText [ fhir:v "2222 Home Street" ]
               ]
             ] [
               fhir:city [
                 fhir:xmlText [ fhir:v "Beaverton" ]
               ]
             ] [
               fhir:state [
                 fhir:xmlText [ fhir:v "OR" ]
               ]
             ] [
               fhir:postalCode [
                 fhir:xmlText [ fhir:v "97867" ]
               ]
             ] [
               fhir:country [
                 fhir:xmlText [ fhir:v "US" ]
               ]
             ] )
           ] ) ;
           fhir:telecom ( [
             fhir:use ( [ fhir:v "MC" ] ) ;
             fhir:value [
               fhir:v "tel:+1(555)555-2008"^^xsd:anyURI ;
               fhir:l fhir:tel:+1(555)555-2008
             ]
           ] ) ;
           fhir:guardianPerson [
             fhir:name ( [
               fhir:item ( [
                 fhir:given ( [
                   fhir:xmlText [ fhir:v "Boris" ]
                 ] )
               ] [
                 fhir:given ( [
                   fhir:xmlText [ fhir:v "Bo" ] ;
                   fhir:qualifier ( [ fhir:v "CL" ] )
                 ] )
               ] [
                 fhir:family ( [
                   fhir:xmlText [ fhir:v "Betterhalf" ]
                 ] )
               ] )
             ] )
           ]
         ] ) ;
         fhir:birthplace [
           fhir:place [
             fhir:addr [
               fhir:item ( [
                 fhir:streetAddressLine [
                   fhir:xmlText [ fhir:v "4444 Home Street" ]
                 ]
               ] [
                 fhir:city [
                   fhir:xmlText [ fhir:v "Beaverton" ]
                 ]
               ] [
                 fhir:state [
                   fhir:xmlText [ fhir:v "OR" ]
                 ]
               ] [
                 fhir:postalCode [
                   fhir:xmlText [ fhir:v "97867" ]
                 ]
               ] [
                 fhir:country [
                   fhir:xmlText [ fhir:v "US" ]
                 ]
               ] )
             ]
           ]
         ] ;
         fhir:languageCommunication ( [
           fhir:languageCode [
             fhir:code [ fhir:v "en" ]
           ] ;
           fhir:modeCode [
             fhir:code [ fhir:v "ESP" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.60" ] ;
             fhir:codeSystemName [ fhir:v "LanguageAbilityMode" ] ;
             fhir:displayName [ fhir:v "Expressed spoken" ]
           ] ;
           fhir:proficiencyLevelCode [
             fhir:code [ fhir:v "G" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.61" ] ;
             fhir:codeSystemName [ fhir:v "LanguageAbilityProficiency" ] ;
             fhir:displayName [ fhir:v "Good" ]
           ] ;
           fhir:preferenceInd [
             fhir:value [ fhir:v true ]
           ] #  Patient's preferred language 
         ] )
       ] ; #  HP is \"primary home\" from HL7 AddressUse 2.16.840.1.113883.5.1119 
       fhir:providerOrganization [
         fhir:id ( [
           fhir:extension [ fhir:v "219BX" ] ;
           fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
         ] ) ;
         fhir:name ( [
           fhir:item ( [
             fhir:xmlText [ fhir:v "The DoctorsTogether Physician Group" ]
           ] )
         ] ) ;
         fhir:telecom ( [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:value [
             fhir:v "tel:+1(555)555-5000"^^xsd:anyURI ;
             fhir:l fhir:tel:+1(555)555-5000
           ]
         ] ) ;
         fhir:addr ( [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:item ( [
             fhir:streetAddressLine [
               fhir:xmlText [ fhir:v "1007 Health Drive" ]
             ]
           ] [
             fhir:city [
               fhir:xmlText [ fhir:v "Portland" ]
             ]
           ] [
             fhir:state [
               fhir:xmlText [ fhir:v "OR" ]
             ]
           ] [
             fhir:postalCode [
               fhir:xmlText [ fhir:v "99123" ]
             ]
           ] [
             fhir:country [
               fhir:xmlText [ fhir:v "US" ]
             ]
           ] )
         ] )
       ]
     ]
  ] ) ; # 
  fhir:author ( [
     fhir:time [
       fhir:value [ fhir:v "2013-03-11T10:30:00-08:00"^^xsd:dateTime ]
     ] ;
     fhir:assignedAuthor [
       fhir:id ( [
         fhir:extension [ fhir:v "5555555555" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
       ] ) ;
       fhir:code [
         fhir:code [ fhir:v "207QA0505X" ] ;
         fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.101" ] ;
         fhir:codeSystemName [ fhir:v "Healthcare Provider Taxonomy (HIPAA)" ] ;
         fhir:displayName [ fhir:v "Adult Medicine" ]
       ] ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1004 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Portland" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "99123" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)-1004"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)-1004
         ]
       ] ) ;
       fhir:assignedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patricia" ]
             ] )
           ] [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patty" ] ;
               fhir:qualifier ( [ fhir:v "CL" ] )
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Primary" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "M.D." ] ;
               fhir:qualifier ( [ fhir:v "AC" ] )
             ] )
           ] )
         ] )
       ]
     ]
  ] ) ; # 
  fhir:dataEnterer [
     fhir:assignedEntity [
       fhir:id ( [
         fhir:extension [ fhir:v "333777777" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
       ] ) ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1007 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Portland" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "99123" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)-1050"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)-1050
         ]
       ] ) ;
       fhir:assignedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Ellen" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Enter" ]
             ] )
           ] )
         ] )
       ]
     ]
  ] ; # 
  fhir:informant ( [
     fhir:assignedEntity [
       fhir:id ( [
         fhir:extension [ fhir:v "888888888" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.19.5" ]
       ] ) ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1007 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Portland" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "99123" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)-1003"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)-1003
         ]
       ] ) ;
       fhir:assignedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Harold" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Hippocrates" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "D.O." ] ;
               fhir:qualifier ( [ fhir:v "AC" ] )
             ] )
           ] )
         ] )
       ]
     ]
  ] ) ; # 
  fhir:custodian [
     fhir:assignedCustodian [
       fhir:representedCustodianOrganization [
         fhir:id ( [
           fhir:extension [ fhir:v "321CX" ] ;
           fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
         ] ) ;
         fhir:name [
           fhir:item ( [
             fhir:xmlText [ fhir:v "Good Health HIE" ]
           ] )
         ] ;
         fhir:telecom [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:value [
             fhir:v "tel:+1(555)-1009"^^xsd:anyURI ;
             fhir:l fhir:tel:+1(555)-1009
           ]
         ] ;
         fhir:addr [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:item ( [
             fhir:streetAddressLine [
               fhir:xmlText [ fhir:v "1009 Healthcare Drive" ]
             ]
           ] [
             fhir:city [
               fhir:xmlText [ fhir:v "Portland" ]
             ]
           ] [
             fhir:state [
               fhir:xmlText [ fhir:v "OR" ]
             ]
           ] [
             fhir:postalCode [
               fhir:xmlText [ fhir:v "99123" ]
             ]
           ] [
             fhir:country [
               fhir:xmlText [ fhir:v "US" ]
             ]
           ] )
         ]
       ]
     ]
  ] ; # 
  fhir:informationRecipient ( [
     fhir:intendedRecipient [
       fhir:informationRecipient [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Nancy" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Nightingale" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "RN" ] ;
               fhir:qualifier ( [ fhir:v "AC" ] )
             ] )
           ] )
         ] )
       ] ;
       fhir:receivedOrganization [
         fhir:name ( [
           fhir:item ( [
             fhir:xmlText [ fhir:v "Community Health and Hospitals" ]
           ] )
         ] ) ;
         fhir:telecom ( [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:value [
             fhir:v "tel:+1(555)-555-1002"^^xsd:anyURI ;
             fhir:l fhir:tel:+1(555)-555-1002
           ]
         ] ) ;
         fhir:addr ( [
           fhir:use ( [ fhir:v "WP" ] ) ;
           fhir:item ( [
             fhir:streetAddressLine [
               fhir:xmlText [ fhir:v "Cardiac Stepdown Unit, 4B" ]
             ]
           ] [
             fhir:streetAddressLine [
               fhir:xmlText [ fhir:v "1002 Healthcare Drive" ]
             ]
           ] [
             fhir:city [
               fhir:xmlText [ fhir:v "Ann Arbor" ]
             ]
           ] [
             fhir:state [
               fhir:xmlText [ fhir:v "MI" ]
             ]
           ] [
             fhir:postalCode [
               fhir:xmlText [ fhir:v "97857" ]
             ]
           ] [
             fhir:country [
               fhir:xmlText [ fhir:v "US" ]
             ]
           ] )
         ] )
       ]
     ]
  ] ) ; # 
  fhir:legalAuthenticator [
     fhir:time [
       fhir:value [ fhir:v "2013-09-15T22:36:15-08:00"^^xsd:dateTime ]
     ] ;
     fhir:signatureCode [
       fhir:code [ fhir:v "S" ]
     ] ;
     fhir:assignedEntity [
       fhir:id ( [
         fhir:extension [ fhir:v "5555555555" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
       ] ) ;
       fhir:code [
         fhir:code [ fhir:v "207QA0505X" ] ;
         fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.101" ] ;
         fhir:codeSystemName [ fhir:v "Healthcare Provider Taxonomy (HIPAA)" ] ;
         fhir:displayName [ fhir:v "Adult Medicine Physician" ]
       ] ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1004 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Portland" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "99123" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)-1004"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)-1004
         ]
       ] ) ;
       fhir:assignedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patricia" ]
             ] )
           ] [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patty" ] ;
               fhir:qualifier ( [ fhir:v "CL" ] )
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Primary" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "M.D." ] ;
               fhir:qualifier ( [ fhir:v "AC" ] )
             ] )
           ] )
         ] )
       ]
     ]
  ] ; # 
  fhir:authenticator ( [
     fhir:time [
       fhir:value [ fhir:v "2012-09-15T10:30:00-08:00"^^xsd:dateTime ]
     ] ;
     fhir:signatureCode [
       fhir:code [ fhir:v "S" ]
     ] ;
     fhir:assignedEntity [
       fhir:id ( [
         fhir:extension [ fhir:v "5555555555" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
       ] ) ;
       fhir:code [
         fhir:code [ fhir:v "207QA0505X" ] ;
         fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.101" ] ;
         fhir:codeSystemName [ fhir:v "Healthcare Provider Taxonomy (HIPAA)" ] ;
         fhir:displayName [ fhir:v "Adult Medicine" ]
       ] ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1004 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Portland" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "OR" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "99123" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:+1(555)-1004"^^xsd:anyURI ;
           fhir:l fhir:tel:+1(555)-1004
         ]
       ] ) ;
       fhir:assignedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patricia" ]
             ] )
           ] [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Patty" ] ;
               fhir:qualifier ( [ fhir:v "CL" ] )
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Primary" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "M.D." ] ;
               fhir:qualifier ( [ fhir:v "AC" ] )
             ] )
           ] )
         ] )
       ]
     ]
  ] ) ; # 
  fhir:participant ( [
     fhir:typeCode [ fhir:v "CALLBCK" ] ;
     fhir:time [
       fhir:value [ fhir:v "2005-03-29T22:44:11+05:00"^^xsd:dateTime ]
     ] ;
     fhir:associatedEntity [
       fhir:classCode [ fhir:v "ASSIGNED" ] ;
       fhir:id ( [
         fhir:extension [ fhir:v "99999999" ] ;
         fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]
       ] ) ;
       fhir:code [
         fhir:code [ fhir:v "200000000X" ] ;
         fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.101" ] ;
         fhir:displayName [ fhir:v "Allopathic & Osteopathic Physicians" ]
       ] ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "1002 Healthcare Drive" ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Ann Arbor" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "MI" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "97857" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:555-555-1002"^^xsd:anyURI ;
           fhir:l fhir:tel:555-555-1002
         ]
       ] ) ;
       fhir:associatedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Henry" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Seven" ]
             ] )
           ] [
             fhir:suffix ( [
               fhir:xmlText [ fhir:v "DO" ]
             ] )
           ] )
         ] )
       ]
     ]
  ] [
     fhir:typeCode [ fhir:v "IND" ] ;
     fhir:functionCode [
       fhir:code [ fhir:v "407543004" ] ;
       fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.96" ] ;
       fhir:codeSystemName [ fhir:v "SNOMED-CT" ] ;
       fhir:displayName [ fhir:v "Primary Carer" ]
     ] ;
     fhir:associatedEntity [
       fhir:classCode [ fhir:v "CAREGIVER" ] ;
       fhir:code [
         fhir:code [ fhir:v "MTH" ] ;
         fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.111" ]
       ] ;
       fhir:addr ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:item ( [
           fhir:streetAddressLine [
             fhir:xmlText [ fhir:v "17 Daws Rd." ]
           ]
         ] [
           fhir:city [
             fhir:xmlText [ fhir:v "Ann Arbor" ]
           ]
         ] [
           fhir:state [
             fhir:xmlText [ fhir:v "MI" ]
           ]
         ] [
           fhir:postalCode [
             fhir:xmlText [ fhir:v "97857" ]
           ]
         ] [
           fhir:country [
             fhir:xmlText [ fhir:v "US" ]
           ]
         ] )
       ] ) ;
       fhir:telecom ( [
         fhir:use ( [ fhir:v "WP" ] ) ;
         fhir:value [
           fhir:v "tel:1+(555)555-1212"^^xsd:anyURI ;
           fhir:l fhir:tel:1+(555)555-1212
         ]
       ] ) ;
       fhir:associatedPerson [
         fhir:name ( [
           fhir:item ( [
             fhir:prefix ( [
               fhir:xmlText [ fhir:v "Mrs." ]
             ] )
           ] [
             fhir:given ( [
               fhir:xmlText [ fhir:v "Martha" ]
             ] )
           ] [
             fhir:family ( [
               fhir:xmlText [ fhir:v "Jones" ]
             ] )
           ] )
         ] )
       ]
     ] #  Caregiver 
  ] ) ; # 
  fhir:component [
     fhir:structuredBody [
       fhir:component ( [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2014-06-09" ] ;
             fhir:root [ fhir:v "1.3.6.1.4.1.19376.1.5.3.1.3.1" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "42349-1" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "Reason for Referral" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "REASON FOR REFERRAL" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2015-08-01" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.6.1" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "48765-2" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "ALLERGIES AND ADVERSE REACTIONS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2015-08-01" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.5.1" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "11450-4" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "PROBLEM LIST" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "PROBLEMS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2014-06-09" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.1.1" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "10160-0" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "HISTORY OF MEDICATION USE" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "MEDICATIONS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2014-06-09" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.10" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "18776-5" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "Treatment plan" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "TREATMENT PLAN" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.8" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "51848-0" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "ASSESSMENTS" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "ASSESSMENTS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2015-08-01" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.3.1" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "30954-2" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "RESULTS" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "RESULTS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2014-06-09" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.14" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "47420-5" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "Functional Status" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "FUNCTIONAL STATUS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:extension [ fhir:v "2015-08-01" ] ;
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.56" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "10190-7" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "Mental status Narrative" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "MENTAL STATUS" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] [
         fhir:section [
           fhir:nullFlavor [ fhir:v "NI" ] ;
           fhir:templateId ( [
             fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.57" ]
           ] ) ;
           fhir:code [
             fhir:code [ fhir:v "61144-2" ] ;
             fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
             fhir:codeSystemName [ fhir:v "LOINC" ] ;
             fhir:displayName [ fhir:v "Diet and Nutrition" ]
           ] ;
           fhir:title [
             fhir:xmlText [ fhir:v "NUTRITION SECTION" ]
           ] ;
           fhir:text [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"^^rdf:XMLLiteral ]
         ]
       ] ) #  Reason for Referral 
     ] #  All sections are set to nullFlavor \/ text = No information, \n        as this is a header example, not a complete body example 
  ]] . # 

# -------------------------------------------------------------------------------------