This page is part of the FHIR Specification (v4.3.0: R4B - STU). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile QuestionnaireResponse.
LinkId | Text | Definition | Answer |
---|---|---|---|
ussg-fht-answers | QuestionnaireResponse | ||
0 | |||
0.1 | Date Done | 2008-01-17 | |
1 | Your health information | ||
1.1 | |||
1.1.1 | Name | Annie Proband | |
1.1.2 | Gender | LOINC LA3-6: Female | |
1.1.3 | Date of Birth | 1966-04-04 | |
1.1.4 | Were you born a twin? | LOINC LA32-8: No | |
1.1.5 | Were you adopted? | LOINC LA32-8: No | |
1.1.6 | Are your parents related to each other in any way other than marriage? | LOINC LA32-8: No | |
1.1.7 | Height | 63 | |
1.1.7.1 | |||
1.1.7.1.1 | Units | UCUM [in_i]: inches | |
1.1.8 | Weight | 127 | |
1.1.8.1 | |||
1.1.8.1.1 | Units | UCUM [lb_av]: pounds | |
1.1.9 | Body mass index (BMI) [Ratio] | 22.5 | |
1.1.10 | Race | LOINC LA4457-3: White | |
1.1.11 | Ethnicity | ||
2 | Family member health information | ||
2.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10405-1: Daughter | |
2.1.1.2 | Name | Susan | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 17 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10415-0: Brother | |
2.1.1.2 | Name | Brian | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 32 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10550-4: -- Other Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10397-0: 30-39 | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10418-4: Sister | |
2.1.1.2 | Name | Janet | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 36 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10536-3: -- Breast Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10397-0: 30-39 | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10419-2: Nephew | |
2.1.1.2 | Name | Ian | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 16 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10420-0: Niece | |
2.1.1.2 | Name | Helen | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 15 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10416-8: Father | |
2.1.1.2 | Name | Donald | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 52 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10425-9: Paternal Uncle | |
2.1.1.2 | Name | Eric | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 56 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10421-8: Paternal Aunt | |
2.1.1.2 | Name | Fiona | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 57 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10543-9: -- Skin Cancer | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10423-4: Paternal Grandfather | |
2.1.1.2 | Name | Bob | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA32-8: No | |
2.1.1.4.1 | |||
2.1.1.4.1.1 | Cause of Death | LOINC LA10537-1: -- Colon Cancer | |
2.1.1.4.1.2 | Age at Death | LOINC LA10400-2: OVER 60 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10537-1: -- Colon Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10400-2: OVER 60 | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10424-2: Paternal Grandmother | |
2.1.1.2 | Name | Claire | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA32-8: No | |
2.1.1.4.1 | |||
2.1.1.4.1.1 | Cause of Death | LOINC LA10589-2: -- Other/Unexpected | |
2.1.1.4.1.1.1 | Please specify | Lou Gehrigs | |
2.1.1.4.1.2 | Age at Death | LOINC LA10400-2: OVER 60 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10417-6: Mother | |
2.1.1.2 | Name | Harriet | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA32-8: No | |
2.1.1.4.1 | |||
2.1.1.4.1.1 | Cause of Death | LOINC LA10539-7: -- Ovarian Cancer | |
2.1.1.4.1.2 | Age at Death | LOINC LA10399-6: 50-59 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10539-7: -- Ovarian Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10398-8: 40-49 | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10414-3: Maternal Uncle | |
2.1.1.2 | Name | Rudy | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 60 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10410-1: Maternal Aunt | |
2.1.1.2 | Name | Julie | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 57 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10412-7: Maternal Grandfather | |
2.1.1.2 | Name | Ian | |
2.1.1.3 | Gender | LOINC LA2-8: Male | |
2.1.1.4 | Living? | LOINC LA32-8: No | |
2.1.1.4.1 | |||
2.1.1.4.1.1 | Cause of Death | LOINC LA10558-7: -- Heart Attack | |
2.1.1.4.1.2 | Age at Death | LOINC LA10400-2: OVER 60 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10413-5: Maternal Grandmother | |
2.1.1.2 | Name | Gladys | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA32-8: No | |
2.1.1.4.1 | |||
2.1.1.4.1.1 | Cause of Death | LOINC LA10571-0: -- Other/Unknown | |
2.1.1.4.1.2 | Age at Death | LOINC LA10400-2: OVER 60 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10536-3: -- Breast Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10399-6: 50-59 | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10564-5: -- Asthma | |
2.1.2.2 | Age at Diagnosis | LOINC LA10395-4: Childhood | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10411-9: Maternal Cousin | |
2.1.1.2 | Name | Karren | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 30 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
2.1.2 | This family member's history of disease | ||
2.1.2.1 | Disease or Condition | LOINC LA10536-3: -- Breast Cancer | |
2.1.2.2 | Age at Diagnosis | LOINC LA10397-0: 30-39 | |
2.1 | |||
2.1.1 | |||
2.1.1.1 | Relationship to you | LOINC LA10411-9: Maternal Cousin | |
2.1.1.2 | Name | Mary | |
2.1.1.3 | Gender | LOINC LA3-6: Female | |
2.1.1.4 | Living? | LOINC LA33-6: Yes | |
2.1.1.4.2 | |||
2.1.1.4.2.2 | Age | 31 | |
2.1.1.5 | Was this person born a twin? | LOINC LA32-8: No | |
2.1.1.6 | Was this person adopted? | LOINC LA32-8: No | |
Documentation for this format |
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.