Vital Records Birth and Fetal Death Reporting
1.0.0 - STU 1

This page is part of the Vital Records Birth and Fetal Death Reporting (v1.0.0: STU 1 on FHIR R4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Patient - Mother example [Eve Everywoman] - XML Representation

Raw xml | Download



<Patient xmlns="http://hl7.org/fhir">
  <id value="patient-mother-jada-ann-quinn"/>
  <meta>
    <versionId value="14"/>
    <lastUpdated value="2021-07-09T03:23:47.262+00:00"/>
    <source value="#5RW1WsnJl4lbLRqv"/>
    <profile
             value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
            <div class="hapiHeaderText">Jada Ann 
                
                
                <b>QUINN </b>
            </div>
            <table class="hapiPropertyTable">
                <tbody>
                    <tr>
                        <td>Identifier</td>
                        <td>132225986</td>
                    </tr>
                    <tr>
                        <td>Address</td>
                        <td>
                            <span>1875 West Morton Avenue </span>
                            <br/>
                            <span>Salt Lake City </span>
                            <span>UT </span>
                            <span>US </span>
                        </td>
                    </tr>
                    <tr>
                        <td>Date of birth</td>
                        <td>
                            <span>15 January 1985</span>
                        </td>
                    </tr>
                </tbody>
            </table>
        </div>
  </text>
  <extension url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2106-3"/>
        <display value="White"/>
      </valueCoding>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1002-5"/>
        <display value="American Indian or Alaska Native"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="White, American Indian or Alaska Native"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2186-5"/>
        <display value="Not Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Not Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/patient-birthPlace">
    <valueAddress>
      <state value="UT"/>
    </valueAddress>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="SS"/>
        <display value="Social Security number"/>
      </coding>
    </type>
    <system value="http://hl7.org/fhir/sid/us-ssn"/>
    <value value="132225986"/>
  </identifier>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <name>
    <use value="official"/>
    <family value="Quinn"/>
    <given value="Jada"/>
    <given value="Ann"/>
  </name>
  <name>
    <use value="maiden"/>
    <family value="King"/>
    <given value="Jada"/>
    <given value="Ann"/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="1-(404)555-1212"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="jadaann.quinn@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="1985-01-15"/>
  <address>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator">
      <valueCoding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
        <code value="Y"/>
        <display value="Yes"/>
      </valueCoding>
    </extension>
    <use value="home"/>
    <line value="1875 West Morton Avenue"/>
    <city value="Salt Lake City"/>
    <district value="Salt Lake"/>
    <state value="UT"/>
    <postalCode value="84116"/>
    <country value="US"/>
  </address>
  <address>
    <use value="billing"/>
    <line value="1848 South 1300 East"/>
    <city value="Salt Lake City"/>
    <state value="UT"/>
    <postalCode value="84401"/>
    <country value="US"/>
  </address>
</Patient>