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 - XML Representation
Raw xml | Download
<Patient xmlns="http://hl7.org/fhir">
<id value="SampleICSRPatient"/>
<meta>
<profile
value="http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-patient"/>
</meta>
<text>
<status value="generated"/>
<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: 123456789)</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>
</text>
<extension
url="http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-ext-militarystatus">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C114854"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="123456789"/>
</identifier>
<name>
<family value="Black"/>
<given value="Irma"/>
</name>
<telecom>
<system value="phone"/>
<value value="+ 1-234-653-6558"/>
</telecom>
<gender value="female"/>
<birthDate value="1998-08-31"/>
<address>
<line value="50878 Coleman Ferry"/>
<city value="Montague"/>
<state value="MA"/>
<country value="US"/>
</address>
</Patient>