This page is part of the Common Data Models Harmonization FHIR IG (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Patient xmlns="http://hl7.org/fhir">
<id value="example"/>
<meta>
<extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
<valueString value="Patient Example"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/instance-description">
<valueMarkdown
value="This is a patient example for the *CDMH Patient Profile*."/>
</extension>
<profile
value="http://hl7.org/fhir/us/cdmh/StructureDefinition/cdmh-patient"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Patient Example</b></p></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/patient-genderIdentity">
<valueCodeableConcept>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2135-2"/>
<display value="Hispanic or Latino"/>
</coding>
</valueCodeableConcept>
</extension>
<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="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="text">
<valueString value="Hispanic"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
<valueCode value="F"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cdmh/StructureDefinition/cdmh-patient-sexualOrientation">
<valueCode value="AS"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cdmh/StructureDefinition/cdmh-pcornet-race">
<valueCode value="05"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cdmh/StructureDefinition/cdmh-pcornet-ethnicity">
<valueCode value="Y"/>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/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."/>
<period>
<start value="2016-12-06"/>
<end value="2020-07-22"/>
</period>
</name>
<name>
<family value="Baxter"/>
<given value="Amy"/>
<given value="V."/>
<suffix value="PharmD"/>
<period>
<start value="2020-07-22"/>
</period>
</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="1987-02-20">
<extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
<valueDateTime value="1987-02-20T13:28:17-05:00"/>
</extension>
</birthDate>
<address>
<line value="49 Meadow St"/>
<city value="Mounds"/>
<state value="OK"/>
<postalCode value="74047"/>
<country value="US"/>
<period>
<start value="2016-12-06"/>
<end value="2020-07-22"/>
</period>
</address>
<address>
<line value="183 Mountain View St"/>
<city value="Mounds"/>
<state value="OK"/>
<postalCode value="74048"/>
<country value="US"/>
<period>
<start value="2020-07-22"/>
</period>
</address>
</Patient>