Birth And Fetal Death (BFDR) - STU2-ballot
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This page is part of the Vital Records Birth and Fetal Death Reporting (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Example Bundle: Bundle - Provider Fetal Death Report - Fetus Not Named

null (OFFICIAL) Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: USUAL))

Generated Narrative: Composition

Resource Composition "composition-provider-fetal-death-not-named"

Profile: Composition - Provider Fetal Death Report

Extension - Fetal Death Report Number: Fetal Death Report ID: 9876

Extension - Fetal Death Local File Number: Fetal Death Report File Number: 11111-11111

Extension - Date received by Registrar: 2019-02-12

identifier: id: 2019NJ9876

status: FINAL

type: U.S. standard report of fetal death - 2003 revision (LOINC#69045-3)

encounter: See above (http://www.example.org/fhir/Encounter/encounter-maternity-carmen-teresa-lee)

date: 2019-01-09

author: See above (http://www.example.org/fhir/Practitioner/practitioner-vital-records-jessica-leung)

title: Provider fetal death report Document


Prenatal records

Clinical information

Fetal delivery information Document [US Standard Report of Fetal Death]

Mother's administrative information

Father's administrative information

Patient's QuestionnaireResponse Section


Additional Document Content


2. http://www.example.org/fhir/Patient/patient-decedent-fetus-not-named (Patient/patient-decedent-fetus-not-named)

null (OFFICIAL) Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: USUAL))


3. http://www.example.org/fhir/Encounter/encounter-maternity-carmen-teresa-lee (Encounter/encounter-maternity-carmen-teresa-lee)

Not done yet


4. http://www.example.org/fhir/Patient/patient-mother-carmen-teresa-lee (Patient/patient-mother-carmen-teresa-lee)

Carmen Teresa Lee (OFFICIAL) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: USUAL))


5. http://www.example.org/fhir/Observation/observation-planned-to-deliver-at-home-not-named (Observation/observation-planned-to-deliver-at-home-not-named)

Generated Narrative: Observation

Resource Observation "observation-planned-to-deliver-at-home-not-named"

Profile: Observation - Planned to Deliver at Home

status: FINAL

code: Mother Planned to deliver at home [US Standard Certificate of Live Birth] (LOINC#73765-0)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: false


6. http://www.example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee (Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-date-of-first-prenatal-care-visit-carmen-teresa-lee"

Profile: Observation - Date of First Prenatal Care Visit

status: FINAL

code: Date first prenatal visit (LOINC#69044-6)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2018-05-18


7. http://www.example.org/fhir/Observation/observation-last-menstrual-period-carmen-teresa-lee (Observation/observation-last-menstrual-period-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-last-menstrual-period-carmen-teresa-lee"

Profile: Observation - Last Menstrual Period

status: FINAL

code: Last menstrual period start date (LOINC#8665-2)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2018-05-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2018-04-18


8. http://www.example.org/fhir/Observation/observation-number-births-now-living-carmen-teresa-lee (Observation/observation-number-births-now-living-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-births-now-living-carmen-teresa-lee"

Profile: Observation - Number of Births Now Living

status: FINAL

code: [#] Births.still living (LOINC#11638-4)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1


9. http://www.example.org/fhir/Observation/observation-number-births-now-dead-carmen-teresa-lee (Observation/observation-number-births-now-dead-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-births-now-dead-carmen-teresa-lee"

Profile: Observation - Number of Births Now Dead

status: FINAL

code: Previous live births now dead # (LOINC#68496-9)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 0


10. http://www.example.org/fhir/Observation/observation-date-of-last-live-birth-carmen-teresa-lee (Observation/observation-date-of-last-live-birth-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-date-of-last-live-birth-carmen-teresa-lee"

Profile: Observation - Date of Last Live Birth

status: FINAL

code: Date of last live birth (LOINC#68499-3 "Date last live birth")

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2016-01-28


11. http://www.example.org/fhir/Observation/observation-mother-height-carmen-teresa-lee (Observation/observation-mother-height-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-height-carmen-teresa-lee"

Profile: Observation - Mother Height

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Body height (LOINC#8302-2)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-01-10

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 65 in (Details: UCUM code [in_i] = '[in_i]')


12. http://www.example.org/fhir/Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee (Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-prepregnancy-weight-carmen-teresa-lee"

Profile: Observation - Mother Prepregnancy Weight

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Body weight --pre current pregnancy (LOINC#56077-1)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 180 [lb_av] (Details: UCUM code [lb_av] = '[lb_av]')


13. http://www.example.org/fhir/Observation/observation-mother-received-wic-food-carmen-teresa-lee (Observation/observation-mother-received-wic-food-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-received-wic-food-carmen-teresa-lee"

Profile: Observation - Mother Recieved WIC Food

status: FINAL

code: Mother WIC food recipient (LOINC#87303-4)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: No (v2 Y/N Indicator#N)


14. http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-1-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX] (LOINC#64794-1)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0


15. http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-2-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: Cigarettes smoked per day by Mother--1st trimester (LOINC#87298-6)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0


16. http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-3-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: Cigarettes smoked per day by Mother--2nd trimester (LOINC#87299-4)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 1


17. http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-4-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX] (LOINC#64795-8)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0


18. http://www.example.org/fhir/Observation/observation-number-previous-cesareans-carmen-teresa-lee (Observation/observation-number-previous-cesareans-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-previous-cesareans-carmen-teresa-lee"

Profile: Observation - Number of Previous Cesareans

status: FINAL

code: Previous cesarean deliveries # (LOINC#68497-7)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1


19. http://www.example.org/fhir/Observation/observation-fetal-presentation-not-named (Observation/observation-fetal-presentation-not-named)

Generated Narrative: Observation

Resource Observation "observation-fetal-presentation-not-named"

Profile: Observation - Fetal Presentation at Birth/Delivery

status: FINAL

code: Fetal presentation--at birth [US Standard Certificate of Live Birth] (LOINC#73761-9)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Breech presentation (finding) (SNOMED CT#6096002)


20. http://www.example.org/fhir/Procedure/procedure-final-route-method-delivery-not-named (Procedure/procedure-final-route-method-delivery-not-named)

Generated Narrative: Procedure

Resource Procedure "procedure-final-route-method-delivery-not-named"

Profile: Procedure - Final Route and Method of Delivery

status: COMPLETED

code: Spontaneous vaginal delivery (SNOMED CT#700000006 "Vaginal delivery of fetus (procedure)")

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))


21. http://www.example.org/fhir/Observation/observation-birth-weight-not-named (Observation/observation-birth-weight-not-named)

Generated Narrative: Observation

Resource Observation "observation-birth-weight-not-named"

Profile: Observation - Birth Weight

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Birth weight Measured (LOINC#8339-4)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-01-10

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1530 g (Details: UCUM code g = 'g')


22. http://www.example.org/fhir/Observation/observation-gestational-age-at-delivery-not-named (Observation/observation-gestational-age-at-delivery-not-named)

Generated Narrative: Observation

Resource Observation "observation-gestational-age-at-delivery-not-named"

Profile: Observation - Gestational Age at Delivery

status: FINAL

code: Gestational age Estimated (LOINC#11884-4)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 20 wk (Details: UCUM code wk = 'wk')


23. http://www.example.org/fhir/Condition/condition-fetal-death-cause-or-condition-not-named (Condition/condition-fetal-death-cause-or-condition-not-named)

Generated Narrative: Condition

Resource Condition "condition-fetal-death-cause-or-condition-not-named"

Profile: Condition - Fetal Death Cause or Condition

category: Encounter Diagnosis (Condition Category Codes#encounter-diagnosis), Initiating cause or condition of fetal death [US Standard Report of Fetal Death] (LOINC#76060-3)

code: Premature rupture of membranes (disorder) (SNOMED CT#44223004)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))


24. http://www.example.org/fhir/Condition/condition-fetal-death-other-significant-cause-not-named (Condition/condition-fetal-death-other-significant-cause-not-named)

Generated Narrative: Condition

Resource Condition "condition-fetal-death-other-significant-cause-not-named"

Profile: Condition - Fetal Death Other Cause or Condition

category: Encounter Diagnosis (Condition Category Codes#encounter-diagnosis), Other significant causes or conditions of fetal death [US Standard Report of Fetal Death] (LOINC#76061-1)

code: Placental insufficiency (disorder) (SNOMED CT#237292005)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))


25. http://www.example.org/fhir/Observation/observation-fetal-death-time-point-not-named (Observation/observation-fetal-death-time-point-not-named)

Generated Narrative: Observation

Resource Observation "observation-fetal-death-time-point-not-named"

Profile: Observation - Fetal Death Time Point

status: FINAL

code: Estimated timing of fetal death [US Standard Report of Fetal Death] (LOINC#73811-2)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Fetal intrapartum death after first assessment (event) (SNOMED CT#434631000124100)


26. http://www.example.org/fhir/Observation/observation-autopsy-performed-not-named (Observation/observation-autopsy-performed-not-named)

Generated Narrative: Observation

Resource Observation "observation-autopsy-performed-not-named"

Profile: Observation - Autopsy Performed Indicator Vital Records

status: FINAL

code: Autopsy was performed (LOINC#85699-7)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Yes (v2 Y/N Indicator#Y)


27. http://www.example.org/fhir/Observation/observation-histological-placental-exam-performed-not-named (Observation/observation-histological-placental-exam-performed-not-named)

Generated Narrative: Observation

Resource Observation "observation-histological-placental-exam-performed-not-named"

Profile: Observation - Histological Placental Exam Performed

status: FINAL

code: Histological placental examination was performed [US Standard Report of Fetal Death] (LOINC#73767-6)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Performed (SNOMED CT#398166005)


28. http://www.example.org/fhir/Observation/observation-autopsy-histological-exam-results-used-not-named (Observation/observation-autopsy-histological-exam-results-used-not-named)

Generated Narrative: Observation

Resource Observation "observation-autopsy-histological-exam-results-used-not-named"

Profile: Observation - Autopsy or Histological Exam Results Used

status: FINAL

code: Autopsy or histological placental examination results were used [US Standard Report of Fetal Death] (LOINC#74498-7)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Yes (v2 Y/N Indicator#Y)


29. http://www.example.org/fhir/Observation/observation-number-deaths-this-delivery-carmen-teresa-lee (Observation/observation-number-deaths-this-delivery-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-deaths-this-delivery-carmen-teresa-lee"

Profile: Observation - Number of Fetal Deaths This Delivery

status: FINAL

code: Number of fetal deaths delivered (LOINC#73772-6)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1


30. http://www.example.org/fhir/Observation/observation-parent-education-level-carmen-teresa-lee (Observation/observation-parent-education-level-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-parent-education-level-carmen-teresa-lee"

Profile: Observation - Education Level Vital Records

status: FINAL

code: Highest level of education Mother (LOINC#57712-2)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 9th through 12th grade; no diploma (Education Level#SEC "Some secondary or high school education")


31. http://www.example.org/fhir/Observation/observation-usual-work-carmen-teresa-lee (Observation/observation-usual-work-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-usual-work-carmen-teresa-lee"

Profile: Observation - Usual Work

Extension - Vital Records Role: mother (RoleCode#MTH)

status: FINAL

code: History of Usual occupation (LOINC#21843-8)

subject: See above (Patient/patient-decedent-fetus-not-named)

focus: See above (RelatedPerson/relatedperson-mother-carmen-teresa-lee)

value: Secretary ()

Components

-CodeValue[x]
*History of Usual industry (LOINC#21844-6)State Agency ()


32. http://www.example.org/fhir/Observation/observation-usual-work-tom-yan-lee (Observation/observation-usual-work-tom-yan-lee)

Generated Narrative: Observation

Resource Observation "observation-usual-work-tom-yan-lee"

Profile: Observation - Usual Work

Extension - Vital Records Role: father (RoleCode#FTH)

status: FINAL

code: History of Usual occupation (LOINC#21843-8)

subject: See above (Patient/patient-decedent-fetus-not-named)

focus: See above (RelatedPerson/relatedperson-father-natural-tom-yan-lee)

value: Teaching Assistant ()

Components

-CodeValue[x]
*History of Usual industry (LOINC#21844-6)Elementary and Secondary Schools ()


33. http://www.example.org/fhir/Observation/observation-input-race-and-ethnicity-carmen-teresa-lee (Observation/observation-input-race-and-ethnicity-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-input-race-and-ethnicity-carmen-teresa-lee"

Profile: Observation - Input Race and Ethnicity Vital Records

status: FINAL

code: Race and Ethnicity Data submitted by Jurisdictions to NCHS (CodeSystem - Local Observation Codes Vital Records#inputraceandethnicityMother)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

component

code: White (Local Component Codes#White)

value: true

component

code: Black Or African American (Local Component Codes#BlackOrAfricanAmerican)

value: true

component

code: American Indian Or Alaska Native (Local Component Codes#AmericanIndianOrAlaskanNative)

value: true

component

code: Asian Indian (Local Component Codes#AsianIndian)

value: false

component

code: Chinese (Local Component Codes#Chinese)

value: false

component

code: Filipino (Local Component Codes#Filipino)

value: false

component

code: Japanese (Local Component Codes#Japanese)

value: false

component

code: Korean (Local Component Codes#Korean)

value: false

component

code: Vietnamese (Local Component Codes#Vietnamese)

value: false

component

code: Other Asian (Local Component Codes#OtherAsian)

value: false

component

code: Native Hawaiian (Local Component Codes#NativeHawaiian)

value: false

component

code: Guamanian Or Chamorro (Local Component Codes#GuamanianOrChamorro)

value: false

component

code: Samoan (Local Component Codes#Samoan)

value: false

component

code: Other Pacific Islander (Local Component Codes#OtherPacificIslander)

value: false

component

code: Other Race (Local Component Codes#OtherRace)

value: false

component

code: First Other Asian Literal (Local Component Codes#FirstOtherAsianLiteral)

value: Malaysian

component

code: First American Indian Or Alaska Native Literal (Local Component Codes#FirstAmericanIndianOrAlaskanNativeLiteral)

value: Arikara

component

code: Hispanic Mexican (Local Component Codes#HispanicMexican)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Cuban (Local Component Codes#HispanicCuban)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Puerto Rican (Local Component Codes#HispanicPuertoRican)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Other (Local Component Codes#HispanicOther)

value: No (v2 Y/N Indicator#N)


34. http://www.example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee (QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee)

LinkIdTextDefinitionAnswerdoco
.. QuestionnaireResponse-patients-fetal-death-carmen-leeQuestionnaireResponse
... mother-current-legal-nameWhat is your current legal name?
... mother-addressWhere do you usually live - that is - where is your household/residence located?
... inside-city-limitsIs this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?
... mother-dobWhat is your date of birth?
... mother-birthplaceIn what State, U.S. territory, or foreign country were you born? Please specify one of the following:
... mother-educationWhat is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).
... mother-ethnicityAre you Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box.
... mother-raceWhat is your race? (Please check one or more races to indicate what you consider yourself to be).
... father-current-legal-nameWhat is the current legal name of your baby's father?
... father-dobWhat is the father's date of birth?
... father-birthplaceIn what State, U.S. territory, or foreign country was the father born? Please specify one of the following:
... receive-wicDid you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?
... mothers-heightWhat is your height?
... mothers-prepregnancy-weightlbs
... mothers-smokingHow many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.

doco Documentation for this format


35. http://www.example.org/fhir/Practitioner/practitioner-vital-records-janet-seito (Practitioner/practitioner-vital-records-janet-seito)

Generated Narrative: Practitioner

Resource Practitioner "practitioner-vital-records-janet-seito"

Profile: Practitioner - Vital Records

identifier: id: #223347044

name: Seito Janet

Qualifications

-Code
*Osteopath (occupation) (SNOMED CT#76231001)


36. http://www.example.org/fhir/Location/location-south-hospital (Location/location-south-hospital)

Generated Narrative: Location

Resource Location "location-south-hospital"

Profile: US Core Location Profile

identifier: id: #116441967701

status: ACTIVE

name: South Hospital

type: Hospital (RoleCode#HOSP)

address: 2100 North Ave Salt Lake City UT 84116 US

managingOrganization: See above (Organization/organization-south-hospital: Organization - South Hospital)


37. http://www.example.org/fhir/Organization/organization-south-hospital (Organization/organization-south-hospital)

Generated Narrative: Organization

Resource Organization "organization-south-hospital"

identifier: id: #5555512

active: true

type: Hospital (RoleCode#HOSP)

name: South Hospital

Contacts

-TelecomAddress
*+1-555-555-1111, mail@southhospital.com2100 North Ave Salt Lake City UT 84116 US


38. http://www.example.org/fhir/RelatedPerson/relatedperson-mother-carmen-teresa-lee (RelatedPerson/relatedperson-mother-carmen-teresa-lee)

Generated Narrative: RelatedPerson

Resource RelatedPerson "relatedperson-mother-carmen-teresa-lee"

Profile: RelatedPerson - Mother Vital Records

US Core Race Extension

url

ombCategory

value: Black or African American (Details: urn:oid:2.16.840.1.113883.6.238 code 2054-5 = '2054-5', stated as 'Black or African American')

url

text

value: Black or African America

US Core Ethnicity Extension

url

ombCategory

value: Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2135-2 = '2135-2', stated as 'Hispanic or Latino')

url

text

value: Hispanic or Latino

active: true

patient: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

relationship: Gestational Mother (RoleCode#GESTM "gestational mother")

name: Carmen Teresa Lee (OFFICIAL)

gender: FEMALE

birthDate: 1986-02-15


39. http://www.example.org/fhir/RelatedPerson/relatedperson-father-natural-tom-yan-lee (RelatedPerson/relatedperson-father-natural-tom-yan-lee)

Generated Narrative: RelatedPerson

Resource RelatedPerson "relatedperson-father-natural-tom-yan-lee"

Profile: RelatedPerson - Father Natural Vital Records

US Core Race Extension

url

ombCategory

value: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')

url

text

value: White

US Core Ethnicity Extension

url

ombCategory

value: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = '2186-5', stated as 'Not Hispanic or Latino')

url

text

value: Not Hispanic or Latino

Extension - RelatedPerson Birth Place Vital Records: NY

active: true

patient: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

relationship: Natural Father (RoleCode#NFTH "natural father")

name: Tom Yan Lee (OFFICIAL)

gender: MALE

birthDate: 1984-02-27


40. http://www.example.org/fhir/Practitioner/practitioner-vital-records-jessica-leung (Practitioner/practitioner-vital-records-jessica-leung)

Generated Narrative: Practitioner

Resource Practitioner "practitioner-vital-records-jessica-leung"

Profile: Practitioner - Vital Records

identifier: id: #223347055

name: Leung Jessica

Qualifications

-Code
*Birth Clerk (NullFlavor#OTH "other")