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
: Patient - Mother Jada Ann Quinn - XML Representation
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<Patient xmlns="http://hl7.org/fhir">
<id value="patient-mother-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr"/>
</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>Jada Ann Quinn (OFFICIAL)</b> female, DoB: 1985-01-15 ( Social Security number: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-ssn.html">#</a>132225986 (use: USUAL))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Ids (see the one above)">Other Id:</td><td colspan="3">Medical Record Number: 1032702 (use: USUAL)</td></tr><tr><td style="background-color: #f3f5da" title="Alternate names (see the one above)">Alt. Name:</td><td colspan="3">Jada Ann King (MAIDEN)</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Details:</td><td colspan="3"><ul><li>ph: 1-(404)555-1212(HOME)</li><li><a href="mailto:jadaann.quinn@example.com">jadaann.quinn@example.com</a></li><li>1875 West Morton Avenue Salt Lake City UT 84116 US (HOME)</li><li>1848 South 1300 East Salt Lake City UT 84401 US (BILLING)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.">US Core Ethnicity Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://terminology.hl7.org/5.0.0/CodeSystem-CDCREC.html#CDCREC-2186-5">CDC Race and Ethnicity</a> 2186-5: Not Hispanic or Latino</li><li>text: Not Hispanic or Latino</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>UT </li></ul></td></tr><tr><td style="background-color: #f3f5da" title="A code classifying the person's sex assigned at birth as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9)."><a href="http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html">US Core Birth Sex Extension:</a></td><td colspan="3"><ul><li>F</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White.">US Core Race Extension:</td><td colspan="3"><ul><li>ombCategory: <a href="http://terminology.hl7.org/5.0.0/CodeSystem-CDCREC.html#CDCREC-1002-5">CDC Race and Ethnicity</a> 1002-5: American Indian or Alaska Native</li><li>text: White, American Indian or Alaska Native</li></ul></td></tr></table></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="1002-5"/>
<display value="American Indian or Alaska Native"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White, American Indian or Alaska Native"/>
</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="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not 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="UT"/>
</valueAddress>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SS"/>
<display value="Social Security number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="132225986"/>
</identifier>
<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="1032702"/>
</identifier>
<name>
<use value="official"/>
<family value="Quinn"/>
<given value="Jada"/>
<given value="Ann"/>
</name>
<name>
<use value="maiden"/>
<family value="King"/>
<given value="Jada"/>
<given value="Ann"/>
</name>
<telecom>
<system value="phone"/>
<value value="1-(404)555-1212"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="jadaann.quinn@example.com"/>
</telecom>
<gender value="female"/>
<birthDate value="1985-01-15"/>
<address>
<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>
<use value="home"/>
<line value="1875 West Morton Avenue"/>
<city value="Salt Lake City"/>
<district value="Salt Lake"/>
<state value="UT"/>
<postalCode value="84116"/>
<country value="US"/>
</address>
<address>
<use value="billing"/>
<line value="1848 South 1300 East"/>
<city value="Salt Lake City"/>
<state value="UT"/>
<postalCode value="84401"/>
<country value="US"/>
</address>
</Patient>
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