Real-world lifelines questionnaire (fictively taken from the patient)

{
  "resourceType" : "Questionnaire",
  "id" : "f201",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <pre>Lifelines Questionnaire 1 part 1\n  1. Do you have allergies?\n  2. General Questions:\n    2.a) What is your gender?\n    2.b) What is your date of birth?\n    2.c) What is your country of birth?\n    2.d) What is your marital status?\n    3. Intoxications:\n      3.a) Do you smoke?\n      3.b) Do you drink alcohol?</pre>\n    </div>"
  },
  "url" : "http://hl7.org/fhir/Questionnaire/f201",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.20.6"
  }],
  "status" : "active",
  "subjectType" : ["Patient"],
  "date" : "2010",
  "code" : [{
    "system" : "http://example.org/system/code/lifelines/nl",
    "code" : "VL 1-1, 18-65_1.2.2",
    "display" : "Lifelines Questionnaire 1 part 1"
  }],
  "item" : [{
    "linkId" : "1",
    "text" : "Do you have allergies?",
    "type" : "boolean"
  },
  {
    "linkId" : "2",
    "text" : "General questions",
    "type" : "group",
    "item" : [{
      "linkId" : "2.1",
      "text" : "What is your gender?",
      "type" : "string"
    },
    {
      "linkId" : "2.2",
      "text" : "What is your date of birth?",
      "type" : "date"
    },
    {
      "linkId" : "2.3",
      "text" : "What is your country of birth?",
      "type" : "string"
    },
    {
      "linkId" : "2.4",
      "text" : "What is your marital status?",
      "type" : "string"
    }]
  },
  {
    "linkId" : "3",
    "text" : "Intoxications",
    "type" : "group",
    "item" : [{
      "linkId" : "3.1",
      "text" : "Do you smoke?",
      "type" : "boolean"
    },
    {
      "linkId" : "3.2",
      "text" : "Do you drink alchohol?",
      "type" : "boolean"
    }]
  }]
}