This page is part of the CCDA: Consolidated CDA Release (v3.0.0: CCDA 3.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. 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
This content is an example of the US Realm Header for Patient Generated Document Logical Model and is not a FHIR Resource
<informant xmlns="urn:hl7-org:v3">
<relatedEntity classCode="PRS">
<!-- relatedEntity cannot have an <id>
<id extension="999.17" root="2.16.840.1.113883.19" /> -->
<code code="SIS" displayName="Sister" codeSystem="2.16.840.1.113883.5.111" codeSystemName="Personal And Legal Relationship Role Type" />
<addr use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Boston</city>
<state>MA</state>
<postalCode>02368</postalCode>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
<country>US</country>
</addr>
<!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<telecom value="tel:(555)555-2004" use="HP" />
<relatedPerson>
<name>
<given>Alice</given>
<family>Everyman</family>
</name>
</relatedPerson>
</relatedEntity>
</informant>