This page is part of the PACIO Advance Directive Information Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) 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-McBee-Patient1"/>
<meta>
<lastUpdated value="2021-04-07T19:55:22+00:00"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
</meta>
<language value="en-US"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>McBee, Roger Rienman</b> male, DoB: 1945-04-01 ( Social Beneficiary Identifier: <a href="http://terminology.hl7.org/5.4.0/NamingSystem-ssn.html">#</a>555-12-1246)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor NI}">NoInformation</span></td></tr><tr><td style="background-color: #f3f5da" title="Other Ids (see the one above)">Other Id:</td><td colspan="3">Driver's License Number: <a href="http://terminology.hl7.org/5.4.0/NamingSystem-FloridaDLN.html">#</a>33487</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Details:</td><td colspan="3"><ul><li><a href="tel:+1(469)238-2858">+1(469)238-2858</a></li><li><a href="tel:+1(214)497-9529">+1(214)497-9529</a></li><li><a href="mailto:rogerb@example.com">rogerb@example.com</a></li><li>12345 Main Street Orlando FL 75219 US </li></ul></td></tr></table></div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SB"/>
<display value="Social Beneficiary Identifier"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="555-12-1246"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="DL"/>
<display value="Driver's License Number"/>
</coding>
</type>
<system value="urn:oid:2.16.840.1.113883.4.3.12"/>
<value value="33487"/>
</identifier>
<active value="true"/>
<name>
<text value="McBee, Roger Rienman"/>
<family value="McBee"/>
<given value="Roger"/>
<given value="Rienman"/>
</name>
<telecom>
<system value="phone"/>
<value value="+1(469)238-2858"/>
<use value="home"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="phone"/>
<value value="+1(214)497-9529"/>
<use value="mobile"/>
<rank value="2"/>
</telecom>
<telecom>
<system value="email"/>
<value value="rogerb@example.com"/>
<use value="mobile"/>
<rank value="3"/>
</telecom>
<gender value="male"/>
<birthDate value="1945-04-01"/>
<address>
<type value="physical"/>
<line value="12345 Main Street"/>
<city value="Orlando"/>
<state value="FL"/>
<postalCode value="75219"/>
<country value="US"/>
</address>
<maritalStatus>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
<code value="NI"/>
</coding>
</maritalStatus>
</Patient>