Questionnaire-example-f201-lifelines.xml

Real-world lifelines questionnaire (fictively taken from the patient) (id = "f201")

Raw XML

<Questionnaire xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative</b>
      </p>
      <p>
        <b>status</b>: completed
      </p>
      <p>
        <b>authored</b>: 18-Jun 2013 0:0
      </p>
      <p>
        <b>subject</b>: Roel
      </p>
      <p>
        <b>author</b>: 
        <a href="practitioner-example-f201-ab.html">UZI-nummer = 12345678901 (official); Dokter Bronsig(official); Male; birthDate: 24-Dec
           1956; Implementation of planned interventions; Medical oncologist</a>
      </p>
      <p>
        <b>source</b>: 
        <a href="practitioner-example-f201-ab.html">UZI-nummer = 12345678901 (official); Dokter Bronsig(official); Male; birthDate: 24-Dec
           1956; Implementation of planned interventions; Medical oncologist</a>
      </p>
      <p>
        <b>name</b>: 
        <span title="Codes: {https://lifelines.nl VL 1-1, 18-65_1.2.2}">Lifelines Questionnaire 1 part 1</span>
      </p>
      <p>
        <b>identifier</b>: Roel's VL 1-1, 18-65_1.2.2 = ?? (temp)
      </p>
      <blockquote>
        <p>
          <b>group</b>
        </p>
        <blockquote>
          <p>
            <b>group</b>
          </p>
        </blockquote>
        <blockquote>
          <p>
            <b>group</b>
          </p>
        </blockquote>
        <blockquote>
          <p>
            <b>group</b>
          </p>
        </blockquote>
      </blockquote>
    </div>
  </text>
  <status value="completed"/>
  <authored value="2013-06-18T00:00:00+01:00"/><!--   Fictive, only the below answers are non-fictive   -->
  <subject>
    <reference value="Patient/f201"/>
    <display value="Roel"/>
  </subject>
  <author>
    <reference value="Practitioner/f201"/>
  </author>
  <source>
    <reference value="Practitioner/f201"/>
  </source>
  <name>
    <coding>
      <system value="https://lifelines.nl"/>
      <code value="VL 1-1, 18-65_1.2.2"/>
      <display value="Lifelines Questionnaire 1 part 1"/>
    </coding>
  </name>
  <identifier>
    <use value="temp"/>
    <label value="Roel's VL 1-1, 18-65_1.2.2"/>
  </identifier>
  <group>
    <group>
      <question><!--   Seperate answer   -->
        <text value="Do you have allergies?"/>
        <answerString value="I am allergic to house dust"/>
      </question>
    </group>
    <group><!--   Answers to general questions   -->
      <header value="General questions"/>
      <question>
        <text value="What is your gender?"/>
        <answerString value="Male"/>
      </question>
      <question>
        <name>
          <text value="What is your date of birth?"/>
        </name>
        <answerDate value="1960-03-13"/>
      </question>
      <question>
        <name>
          <text value="What is your country of birth?"/>
        </name>
        <answerString value="The Netherlands"/>
      </question>
      <question>
        <name>
          <text value="What is your marital status?"/>
        </name>
        <answerString value="married"/>
      </question>
    </group>
    <group><!--   Answers to intoxications   -->
      <header value="Intoxications"/>
      <question>
        <text value="Do you smoke?"/>
        <answerString value="No"/>
      </question>
      <question>
        <text value="Do you drink alchohol?"/>
        <answerString value="No, but I used to drink"/>
      </question>
    </group>
  </group>
</Questionnaire>