This page is part of the Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting (v1.0.1: STU 1 Update) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
: Sample ICSR Report Patient - JSON Representation
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{
"resourceType" : "Patient",
"id" : "SampleICSRPatient",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Irma Black </b> female, DoB: 1998-08-31 ( id:\u00a0123456789)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Details:</td><td colspan=\"3\"><ul><li><a href=\"tel:+1-234-653-6558\">+ 1-234-653-6558</a></li><li>50878 Coleman Ferry Montague MA US </li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Information on the military status of the ICSR Patient\"><a href=\"StructureDefinition-icsr-ext-militarystatus.html\">null:</a></td><td colspan=\"3\"><ul><li><span title=\"Codes: {http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C114854}\">C114854</span></li></ul></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-ext-militarystatus",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
"code" : "C114854"
}
]
}
}
],
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-ssn",
"value" : "123456789"
}
],
"name" : [
{
"family" : "Black",
"given" : [
"Irma"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "+ 1-234-653-6558"
}
],
"gender" : "female",
"birthDate" : "1998-08-31",
"address" : [
{
"line" : [
"50878 Coleman Ferry"
],
"city" : "Montague",
"state" : "MA",
"country" : "US"
}
]
}