This page is part of the C-CDA on FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

• Content
• XML
• JSON

<Patient xmlns="http://hl7.org/fhir">
  <id value="patient-1"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: example</p>
      <p>
        <b>identifier</b>: Medical Record Number = 1032702 (USUAL)</p>
      <p>
        <b>active</b>: true</p>
      <p>
        <b>name</b>: Amy V. Shaw </p>
      <p>
        <b>telecom</b>: ph: 555-555-5555(HOME), amy.shaw@example.com</p>
      <p>
        <b>gender</b>: </p>
      <p>
        <b>birthsex</b>: Female</p>
      <p>
        <b>birthDate</b>: Feb 20, 2007</p>
      <p>
        <b>address</b>: 49 Meadow St Mounds OK 74047 US </p>
      <p>
        <b>race</b>: White, American Indian or Alaska Native, Asian, Shoshone, Filipino</p>
      <p>
        <b>ethnicity</b>: Hispanic or Latino, Dominican, Mexican</p>
    </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="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2028-9"/>
        <display value="Asian"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1586-7"/>
        <display value="Shoshone"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2036-2"/>
        <display value="Filipino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Mixed"/>
    </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="2135-2"/>
        <display value="Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2184-0"/>
        <display value="Dominican"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2148-5"/>
        <display value="Mexican"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/v2/0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
      <text value="Medical Record Number"/>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Shaw"/>
    <given value="Amy"/>
    <given value="V."/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="555-555-5555"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="amy.shaw@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="2007-02-20"/>
  <address>
    <line value="49 Meadow St"/>
    <city value="Mounds"/>
    <state value="OK"/>
    <postalCode value="74047"/>
    <country value="US"/>
  </address>
</Patient>