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

Facility Worksheet for Fetal Death

Example of a completed Facility Worksheet for the Fetal Death Report:

Example Facility Worksheet for Fetal Death Report - p1
Example Facility Worksheet for Fetal Death Report - p2
Example Facility Worksheet for Fetal Death Report - p3
Example Facility Worksheet for Fetal Death Report - p4
Example Facility Worksheet for Fetal Death Report - p5
Example Facility Worksheet for Fetal Death Report - p6