This page is part of the Vital Records Death Reporting FHIR Implementation Guide (v3.0.0-ballot: STU 3 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.2.0. For a full list of available versions, see the Directory of published versions

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: DecedentUT-Example1 - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="DecedentUT-Example1"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent"/>
  </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>Davis Lineberry (Official)</b> male, DoB: 2021-03-04 ( Social Security number/429471420)</p><hr/><table class="grid"><tr><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-MaritalStatus S}">Never Married</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3">2722 N Pin Oak Dr Laramie WY 82070 US </td></tr><tr><td style="background-color: #f3f5da" title="Sex on visual inspection at the time of death by the funeral home"><a href="StructureDefinition-NVSS-SexAtDeath.html">NVSS SexAtDeath:</a></td><td colspan="3"><ul><li><span title="Codes: {http://hl7.org/fhir/administrative-gender male}">Male</span></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>CO US (old)</li></ul></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/vrdr/StructureDefinition/NVSS-SexAtDeath">
    <valueCodeableConcept>
      <coding>
        <system value="http://hl7.org/fhir/administrative-gender"/>
        <code value="male"/>
        <display value="Male"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/patient-birthPlace">
    <valueAddress>
      <use value="old"/>
      <state value="CO"/>
      <country value="US"/>
    </valueAddress>
  </extension>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="SS"/>
      </coding>
    </type>
    <system value="http://hl7.org/fhir/sid/us-ssn"/>
    <value value="429471420"/>
  </identifier>
  <name>
    <use value="official"/>
    <family value="Lineberry"/>
    <given value="Davis"/>
    <suffix value="Jr"/>
  </name>
  <gender value="male"/>
  <birthDate value="2021-03-04">
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/ExtensionPartialDateTimeVitalRecords">
      <extension url="year">
        <valueUnsignedInt value="2021"/>
      </extension>
      <extension url="month">
        <valueUnsignedInt value="3"/>
      </extension>
      <extension url="day">
        <valueUnsignedInt value="4"/>
      </extension>
    </extension>
  </birthDate>
  <address>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetNumber">
      <valueString value="2722"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/PreDirectional">
      <valueString value="N"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetName">
      <valueString value="Pin Oak"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetDesignator">
      <valueString value="Dr"/>
    </extension>
    <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/v2-0136"/>
        <code value="Y"/>
        <display value="Yes"/>
      </valueCoding>
    </extension>
    <line value="2722 N Pin Oak Dr"/>
    <city value="Laramie">
      <extension
                 url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CityCode">
        <valuePositiveInt value="45050"/>
      </extension>
    </city>
    <district value="Albany">
      <extension
                 url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/DistrictCode">
        <valuePositiveInt value="1"/>
      </extension>
    </district>
    <state value="WY"/>
    <postalCode value="82070"/>
    <country value="US"/>
  </address>
  <maritalStatus>
    <extension
               url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/vrdr/CodeSystem/CodeSystem-vr-edit-flags"/>
          <code value="0"/>
          <display value="Edit Passed"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
      <code value="S"/>
      <display value="Never Married"/>
    </coding>
  </maritalStatus>
</Patient>