Vital Records Common Profiles Library
1.1.0 - STU 1.1 United States of America flag

This page is part of the Vital Records Common Profile Library (v1.1.0: 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 - Mother - Jada Ann Quinn - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="patient-mother-jada-ann-quinn-common"/>
  <meta>
    <versionId value="6"/>
    <lastUpdated value="2023-06-23T05:09:45.308Z"/>
    <profile
             value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr"/>
  </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>Jada Ann Quinn (OFFICIAL)</b> female, DoB: 1985-01-15 ( Social Security number: 132225986 (use: USUAL))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Ids (see the one above)">Other Id:</td><td colspan="3">Medical Record Number: 1032702 (use: USUAL)</td></tr><tr><td style="background-color: #f3f5da" title="Alternate names (see the one above)">Alt. Name:</td><td colspan="3">Jada Ann King (MAIDEN)</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Details:</td><td colspan="3"><ul><li>ph: 1-(404)555-1212(HOME)</li><li><a href="mailto:jadaann.quinn@example.com">jadaann.quinn@example.com</a></li><li>1875 West Morton Avenue Salt Lake City UT 84116 US (HOME)</li><li>1848 South 1300 East Salt Lake City UT 84401 US (BILLING)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity.  The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.">US Core Ethnicity Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2186-5">Race &amp; Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements."><a href="http://hl7.org/fhir/R4/extension-patient-birthplace.html">Birth Place:</a></td><td colspan="3"><ul><li>UT </li></ul></td></tr><tr><td style="background-color: #f3f5da" title="A code classifying the person's sex assigned at birth  as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)."><a href="http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html">US Core Birth Sex Extension:</a></td><td colspan="3"><ul><li>F</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

 - American Indian or Alaska Native
 - Asian
 - Black or African American
 - Native Hawaiian or Other Pacific Islander
 - White.">US Core Race Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2106-3">Race &amp; Ethnicity - CDC</a> 2106-3: White</li><li>ombCategory: <a href="http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-1002-5">Race &amp; Ethnicity - CDC</a> 1002-5: American Indian or Alaska Native</li><li>text: White, American Indian or Alaska Native</li></ul></td></tr></table></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="text">
      <valueString value="White, American Indian or Alaska Native"/>
    </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="2186-5"/>
        <display value="Not Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Not Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/patient-birthPlace">
    <valueAddress>
      <state value="UT"/>
    </valueAddress>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="SS"/>
        <display value="Social Security number"/>
      </coding>
    </type>
    <system value="http://hl7.org/fhir/sid/us-ssn"/>
    <value value="132225986"/>
  </identifier>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <name>
    <use value="official"/>
    <family value="Quinn"/>
    <given value="Jada"/>
    <given value="Ann"/>
  </name>
  <name>
    <use value="maiden"/>
    <family value="King"/>
    <given value="Jada"/>
    <given value="Ann"/>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="1-(404)555-1212"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="jadaann.quinn@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="1985-01-15"/>
  <address>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator-vr">
      <valueCoding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
        <code value="Y"/>
        <display value="Yes"/>
      </valueCoding>
    </extension>
    <use value="home"/>
    <line value="1875 West Morton Avenue"/>
    <city value="Salt Lake City"/>
    <district value="Salt Lake"/>
    <state value="UT"/>
    <postalCode value="84116"/>
    <country value="US"/>
  </address>
  <address>
    <use value="billing"/>
    <line value="1848 South 1300 East"/>
    <city value="Salt Lake City"/>
    <state value="UT"/>
    <postalCode value="84401"/>
    <country value="US"/>
  </address>
</Patient>