This page is part of the Vital Records Common Profile Library (v1.0.0: STU 1 on FHIR R4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
<Patient xmlns="http://hl7.org/fhir">
<id value="patient-mother-birth-date-part-absent-common"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2021-07-23T01:31:51.537+00:00"/>
<source value="#SgNiS77PjW6IJ7R5"/>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><blockquote><p><b>US Core Race Extension</b></p><p><b>value</b>: <span title="{urn:oid:2.16.840.1.113883.6.238 2054-5}">Black or African American</span></p><p><b>value</b>: Black or African America</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><p><b>value</b>: <span title="{urn:oid:2.16.840.1.113883.6.238 2135-2}">Hispanic or Latino</span></p><p><b>value</b>: Hispanic or Latino</p></blockquote><p><b>US Core Birth Sex Extension</b>: F</p><p><b>Birth Place</b>: PR </p><p><b>identifier</b>: Medical Record Number: 9992702 (USUAL)</p><p><b>name</b>: Carmen Teresa Lee (OFFICIAL), Carmen Teresa Santos (MAIDEN)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1986-01-01</p><p><b>address</b>: 3670 Miller Road Ann Arbor MI 48103 US (HOME)</p></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="2054-5"/>
<display value="Black or African American"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Black or African America"/>
</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 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="PR"/>
</valueAddress>
</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>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="9992702"/>
</identifier>
<name>
<use value="official"/>
<family value="Lee"/>
<given value="Carmen"/>
<given value="Teresa"/>
</name>
<name>
<use value="maiden"/>
<family value="Santos"/>
<given value="Carmen"/>
<given value="Teresa"/>
</name>
<gender value="female"/>
<birthDate value="1986">
<extension
url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-date-part-absent-reason">
<extension url="date-part">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="258706009"/>
<display value="month (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="absent-reason">
<valueCode value="asked-unknown"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-date-part-absent-reason">
<extension url="date-part">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="258703001"/>
<display value="day (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="absent-reason">
<valueCode value="asked-unknown"/>
</extension>
</extension>
</birthDate>
<address>
<extension
url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="N"/>
<display value="No"/>
</valueCoding>
</extension>
<use value="home"/>
<line value="3670 Miller Road"/>
<city value="Ann Arbor"/>
<state value="MI"/>
<postalCode value="48103"/>
<country value="US"/>
</address>
</Patient>