Vital Records Birth and Fetal Death Reporting
0.1.0 - STU 1 Ballot

This page is part of the Vital Records Birth and Fetal Death Reporting (v0.1.0: STU 1 on FHIR R4 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Appendix D - Example Fetal Death Report

Previous Page - Appendix C - Example Facility Worksheet for the Fetal Death Report

Example of a completed Fetal Death Report:

Example Death Report - p1
Example Death Report - p2

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