This page is part of the C-CDA on FHIR Implementation Guide (v1.6.0: STU 1 Ballot 1) based on FHIR v1.6.0. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

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  <meta>
    <versionId value="1"/>
    <lastUpdated value="2016-06-15T08:16:14Z"/>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/ccda-discharge-summary-composition"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>Discharge Summary document for Henry Jones</p>
      <p>Managed by Community Health and Hospitals</p>
    </div>
  </text>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-data-enterer-extension">
    <valueUri value="http://fhirtest.uhn.ca/baseDstu3/Practitioner/117497"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-informant-extension">
    <valueUri value="http://fhirtest.uhn.ca/baseDstu3/Practitioner/117497"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-information-recipient-extension">
    <valueUri value="http://fhirtest.uhn.ca/baseDstu3/Practitioner/117497"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-participant-extension">
    <valueUri value="http://fhirtest.uhn.ca/baseDstu3/RelatedPerson/117466"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-performer-extension">
    <valueUri value="http://fhirtest.uhn.ca/baseDstu3/Practitioner/117497"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/ccda/StructureDefinition/ccda-authorization-extension">
    <valueUri value="http://hl7.org/fhir/ccda/StructureDefinition/ccda-consent"/>
  </extension>
  <identifier>
    <system
            value="http://hl7.org/fhir/ccda/StructureDefinition/ccda-discharge-summary-composition"/>
    <value value="1"/>
  </identifier>
  <date value="2016-02-14T09:10:14Z"/>
  <type>
    <coding>
      <system value="http://loinc.org"/>
      <code value="18842-5"/>
      <display value="Discharge Summary"/>
    </coding>
  </type>
  <title value="Discharge Summary(CCoF)"/>
  <status value="preliminary"/>
  <confidentiality value="N"/>
<!--   Patient Resource  -->
  <subject>
    <reference value="http://fhirtest.uhn.ca/baseDstu3/Patient/117467"/>
    <display value="Henry Jones"/>
  </subject>
<!--   Practitioner Resource  -->
  <author>
    <reference value="http://fhirtest.uhn.ca/baseDstu3/Practitioner/117497"/>
    <display value="Adam Everyman, MD"/>
  </author>
<!--   Organization Resource  -->
  <custodian>
    <reference value="http://fhirtest.uhn.ca/baseDstu3/Organization/117471"/>
    <display value="Community Health and Hospitals"/>
  </custodian>
<!--   Encounter Resource  -->
  <encounter>
    <reference value="http://fhirtest.uhn.ca/baseDstu3/Encounter/117630"/>
  </encounter>
<!--   Allergies and Intolerances Section Narrative  -->
  <section>
    <title value="Allergies and Intolerances Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="48765-2"/>
        <display value="Allergies and adverse reactions"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Substance</b>
            </td>
            <td>
              <b>Overall Severity</b>
            </td>
            <td>
              <b>Reaction</b>
            </td>
            <td>
              <b>Reaction Severity</b>
            </td>
            <td>
              <b>Status</b>
            </td>
          </tr>
          <tr>
            <td>Cashew Nut</td>
            <td>Severe</td>
            <td>Anaphylactic reaction</td>
            <td>Mild</td>
            <td>Active</td>
          </tr>
        </table>
      </div>
    </text>
    <mode value="snapshot"/>
    <orderedBy>
      <coding>
        <system value="http://hl7.org/fhir/list-order"/>
        <code value="event-date"/>
        <display value="Sorted by Event Date"/>
      </coding>
    </orderedBy>
  <!--   Allergies and Intolerances Section Resource  -->
    <entry>
      <reference
                 value="http://fhirtest.uhn.ca/baseDstu3/AllergyIntolerance/117632"/>
    </entry>
  </section>
<!--   Chief Complaint and Reason for Visit Section Narrative  -->
  <section>
    <title value="Chief Complaint and Reason for Visit Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="46239-0"/>
        <display value="Chief complaint and reason for visit"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Cramping, bloating, and constipation.</p>
      </div>
    </text>
  </section>
<!--   Chief Complaint Section Narrative  -->
  <section>
    <title value="Chief Complaint Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10154-3"/>
        <display value="Chief complaint"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Dark Stools</p>
      </div>
    </text>
  </section>
<!--   Reason for Visit Section Narrative  -->
  <section>
    <title value="Reason for Visit Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="29299-5"/>
        <display value="Reason for visit"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Tenderness of lower abdomen</p>
      </div>
    </text>
  </section>
<!--   Admission Diagnosis Section Narrative  -->
  <section>
    <title value="Admission Diagnosis Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="46241-6"/>
        <display value="Hospital admission diagnosis"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Appendicitis</p>
      </div>
    </text>
  </section>
<!--   Admission Medications Section Narrative  -->
  <section>
    <title value="Admission Medications Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="42346-7"/>
        <display value="Medications on admission"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Medication</b>
            </td>
            <td>
              <b>Directions</b>
            </td>
            <td>
              <b>Start Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
            <td>
              <b>Indications</b>
            </td>
            <td>
              <b>Fill Instructions</b>
            </td>
          </tr>
          <tr>
            <td>Pepcid Complete (MAGNESIUM HYDROXIDE0</td>
            <td>Chew one tablet completely and swallow as needed </td>
            <td>20151029</td>
            <td>Active</td>
            <td>Bloating</td>
            <td>Generic substitution allowed</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   History of Past Illness Section Narrative  -->
  <section>
    <title value="History of Past Illness Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11348-0"/>
        <display value="History of past illness"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Problem Name</b>
            </td>
            <td>
              <b>Type</b>
            </td>
            <td>
              <b>Onset Date</b>
            </td>
            <td>
              <b>Abatement Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
          </tr>
          <tr>
            <td>Fever</td>
            <td>Condition</td>
            <td>2016-04-01</td>
            <td>2016-04-14</td>
            <td>Complete</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   History of Past Illness Section Condition Resource  -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Condition/117648"/>
    </entry>
  </section>
<!--   History of Present Illness Section Narrative  -->
  <section>
    <title value="History of Present Illness Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10164-2"/>
        <display value="History of present illness"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>This patient was only recently discharged for a recurrent GI bleed as described below. </p>
        <p>He presented to the ER today c/o a dark stool yesterday but a normal brown
                    stool today. On exam he was hypotensive in the 80?s resolved after .... .... .... </p>
        <p>Lab at discharge: Glucose 112, BUN 16, creatinine 1.1, electrolytes normal.
                    H. pylori antibody pending. Admission hematocrit 16%, discharge hematocrit 29%. WBC
                    7300, platelet count 256,000. Urinalysis normal. Urine culture: No growth. INR 1.1,
                    PTT 40. </p>
        <p>He was transfused with 6 units of packed red blood cells with .... .... .... </p>
        <p>GI evaluation 12 September: Colonoscopy showed single red clot in .... ........ </p>
      </div>
    </text>
  </section>
<!--   Review of Systems Section Narrative  -->
  <section>
    <title value="Review of Systems Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10187-3"/>
        <display value="Review of systems"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Patient denies recent history of fever or malaise. Positive for weakness and
                    shortness of breath. One episode of melena. No recent headaches. Positive for
                    osteoarthritis in hips, knees and hands. </p>
      </div>
    </text>
  </section>
<!--   Family History Section Narrative  -->
  <section>
    <title value="Family History Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10157-6"/>
        <display value="History of family member diseases"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Relationship</b>
            </td>
            <td>
              <b>Diagnosis</b>
            </td>
            <td>
              <b>Age at Onset</b>
            </td>
          </tr>
          <tr>
            <td>Father</td>
            <td>Myocardial Infarction(cause of Death)</td>
            <td>57</td>
          </tr>
          <tr>
            <td>Father</td>
            <td>Diabetes</td>
            <td>40</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Family History Section Resource  -->
    <entry>
      <reference
                 value="http://fhirtest.uhn.ca/baseDstu3/FamilyMemberHistory/117652"/>
    </entry>
  </section>
<!--   Social History Section Narrative  -->
  <section>
    <title value="Social History Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="29762-2"/>
        <display value="Social history"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Social History Element</b>
            </td>
            <td>
              <b>Description</b>
            </td>
            <td>
              <b>Effective Dates</b>
            </td>
          </tr>
          <tr>
            <td>Smoking</td>
            <td>1 pack tobacco per day</td>
            <td>2005/05/01 - 2010/02/28</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Social History Section Observation Resource -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Observation/117688"/>
    </entry>
  </section>
<!--   Functional Status Section Narrative  -->
  <section>
    <title value="Functional Status Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="47420-5"/>
        <display value="Functional status"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Functional or Cognitive Finding</b>
            </td>
            <td>
              <b>Observation</b>
            </td>
            <td>
              <b>Observation Date</b>
            </td>
            <td>
              <b>Condition Status</b>
            </td>
          </tr>
          <tr>
            <td>Ambulation (Dependent to Independent</td>
            <td>Independently able</td>
            <td>2010/03/11</td>
            <td>Active</td>
          </tr>
          <tr>
            <td>Finding of Functional Performance and Activity</td>
            <td>Dyspnea</td>
            <td>2008/02/16</td>
            <td>Active</td>
          </tr>
          <tr>
            <td>Cognitive Function Finding</td>
            <td>Memory Impairment</td>
            <td>2014/04/29</td>
            <td>Active</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   Hospital Course Section Narrative  -->
  <section>
    <title value="Hospital Course Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8648-8"/>
        <display value="Hospital course"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Following a colonoscopy, the patient was admitted and started on Lovenox and
                    nitroglycerin paste. The patient had serial cardiac enzymes and was ruled out for
                    myocardial infarction. The patient underwent a dual isotope stress test. There was no
                    evidence of reversible ischemia on the Cardiolite scan. The patient has been ambulated.
                    The patient had a Holter monitor placed but the report is not available at this time.
                    The patient has remained hemodynamically stable. Will discharge.</p>
      </div>
    </text>
  </section>
<!--   Hospital Consultations Section Narrative  -->
  <section>
    <title value="Hospital Consultations Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="18841-7"/>
        <display value="Hospital consultations"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>listType=&quot;ordered&quot;</p>
        <p>Gastroenterology</p>
        <p>Cardiology</p>
        <p>Dietitian</p>
      </div>
    </text>
  </section>
<!--   Plan of Treatment Section Narrative  -->
  <section>
    <title value="Plan of Treatment Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="18776-5"/>
        <display value="Plan of treatment"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Planned Activity</b>
            </td>
            <td>
              <b>Period</b>
            </td>
            <td>
              <b>Status</b>
            </td>
          </tr>
          <tr>
            <td>Colonoscopy</td>
            <td>2010/08/16 - 2010/08/16</td>
            <td>Completed</td>
          </tr>
          <tr>
            <td>Recommendation to Exercise</td>
            <td>2015/10/29</td>
            <td>Ongoing</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   Problem Section Narrative  -->
  <section>
    <title value="Problem Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11450-4"/>
        <display value="Problem list"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Problem Name</b>
            </td>
            <td>
              <b>Type</b>
            </td>
            <td>
              <b>Onset Date</b>
            </td>
            <td>
              <b>Abatement Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
          </tr>
          <tr>
            <td>Fever</td>
            <td>Condition</td>
            <td>2016-04-01</td>
            <td>2016-04-14</td>
            <td>Complete</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Problem Section Condition Resource  -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Condition/117648"/>
    </entry>
  </section>
<!--   Procedures Section Narrative  -->
  <section>
    <title value="Procedures Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="47519-4"/>
        <display value="History of procedures"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Procedure Name</b>
            </td>
            <td>
              <b>Body Site</b>
            </td>
            <td>
              <b>Performer</b>
            </td>
            <td>
              <b>Date Performed</b>
            </td>
            <td>
              <b>Reason</b>
            </td>
          </tr>
          <tr>
            <td>Appendectomy (Procedure)</td>
            <td>Abdomen</td>
            <td>Dr. Adam Everyman</td>
            <td>20160405</td>
            <td>Generalized abdominal pain 24 hours. Localized in RIF with rebound and guarding</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Procedures Section Resource  -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Procedure/117687"/>
    </entry>
  </section>
<!--   Discharge Diagnosis Section Narrative  -->
  <section>
    <title value="Discharge Diagnosis Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11535-2"/>
        <display value=" Hospital discharge diagnosis"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Diverticula of intestine</p>
      </div>
    </text>
  </section>
<!--   Discharge Medications Section (entries optional) Narrative  -->
  <section>
    <title value="Discharge Medications Section (entries optional)"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10183-2"/>
        <display value="Hospital discharge medications"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Medication</b>
            </td>
            <td>
              <b>Directions</b>
            </td>
            <td>
              <b>Start Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
            <td>
              <b>Indications</b>
            </td>
            <td>
              <b>Fill Instructions</b>
            </td>
          </tr>
          <tr>
            <td>Proventil HFA</td>
            <td>Inhalant solution - 2 puffs QID PRN wheezing</td>
            <td>20151029</td>
            <td>Active</td>
            <td>Pneumonia</td>
            <td>Generic substitution allowed</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   Discharge Medications Section (entries required) Narrative  -->
  <section>
    <title value="Discharge Medications Section (entries required)"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10183-2"/>
        <display value="Hospital discharge medications"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Medication</b>
            </td>
            <td>
              <b>Directions</b>
            </td>
            <td>
              <b>Start Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
            <td>
              <b>Indications</b>
            </td>
            <td>
              <b>Fill Instructions</b>
            </td>
          </tr>
          <tr>
            <td>Acetaminophen Tab 325 mg</td>
            <td>Take 2 tablet(s) every four hours if needed</td>
            <td>20151029</td>
            <td>Active</td>
            <td>Pain management</td>
            <td>Generic substitution allowed</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   Hospital Discharge Instructions Section Narrative  -->
  <section>
    <title value="Hospital Discharge Instructions Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8653-8"/>
        <display value="Hospital discharge instructions"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>Take all of your prescription medication as directed. </p>
        <p>Make an appointment with your doctor to be seen two weeks from the date of your procedure. </p>
        <p>You may feel slightly bloated after the procedure because of air that was
                    introduced during the examination. </p>
        <p> Call your physician if you notice: <br/> Bleeding or black stools. <br/>
                    Abdominal pain. <br/> Fever or chills. <br/> Nausea or vomiting. <br/> Any unusual
                    pain or problem. <br/> Pain or redness at the site where the intravenous needle was
                    placed. <br/>
                </p>
        <p>Do not drink alcohol for 24 hours. Alcohol amplifies the effect of the sedatives given. </p>
        <p>Do not drive or operate machinery for 24 hours.</p>
      </div>
    </text>
  </section>
<!--   Hospital Discharge Physical Section Narrative  -->
  <section>
    <title value="Hospital Discharge Physical Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10184-0"/>
        <display value="Hospital discharge physical"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <p>GENERAL: Well-developed, slightly obese man. </p>
        <p>NECK: Supple, with no jugular venous distension.</p>
        <p>HEART: Intermittent tachycardia without murmurs or gallops. </p>
        <p>PULMONARY: Decreased breath sounds, but no clear-cut rales or wheezes.</p>
        <p>EXTREMITIES: Free of edema.</p>
      </div>
    </text>
  </section>
<!--   Hospital Discharge Studies Section Narrative  -->
  <section>
    <title value="Hospital Discharge Studies Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11493-4"/>
        <display value="Hospital discharge studies summary"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table border="1" width="100%">
          <thead>
            <tr>
              <th>Laboratory Information</th>
              <th>Chemistries and drug levels</th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td>Potasium</td>
              <td>4.0</td>
            </tr>
            <tr>
              <td>NA (135-145meq/l)</td>
              <td>140</td>
            </tr>
          </tbody>
        </table>
        <br/>
        <table border="1" width="100%">
          <thead>
            <tr>
              <th>Other Tests</th>
              <th>Results</th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td>EKG</td>
              <td>Sinus rhythm without acute changes.</td>
            </tr>
          </tbody>
        </table>
      </div>
    </text>
  </section>
<!--   Immunizations Section Narrative  -->
  <section>
    <title value="Immunizations Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11369-6"/>
        <display value="History of immunization"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Vaccine</b>
            </td>
            <td>
              <b>Date</b>
            </td>
            <td>
              <b>Status</b>
            </td>
          </tr>
          <tr>
            <td>Fluvax (Influenza)</td>
            <td>2016-04-05</td>
            <td>Completed</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Immunizations Section Resource  -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Immunization/117678"/>
    </entry>
  </section>
<!--   Nutrition Section Narrative  -->
  <section>
    <title value=" Nutrition Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="61144-2"/>
        <display value="Diet and nutrition"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Date</b>
            </td>
            <td>
              <b>Nutritional Status</b>
            </td>
            <td>
              <b>Diet</b>
            </td>
          </tr>
          <tr>
            <td>2005/12/29</td>
            <td>Well nourished</td>
            <td>Low sodium diet, excessive carbohydrate</td>
          </tr>
          <tr>
            <td>2010/05/26</td>
            <td>Slight dehydration</td>
            <td>High protein, low fibre</td>
          </tr>
        </table>
      </div>
    </text>
  </section>
<!--   Vital Signs Section Narrative  -->
  <section>
    <title value="Vital Signs Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8716-3"/>
        <display value="Vital signs"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <tr>
            <td>
              <b>Vital Sign</b>
            </td>
            <td>
              <b>Date</b>
            </td>
            <td>
              <b>Value</b>
            </td>
          </tr>
          <tr>
            <td>Temperature</td>
            <td>2016/04/05</td>
            <td>39 Degrees Celcius</td>
          </tr>
        </table>
      </div>
    </text>
  <!--   Vital Signs Section Observation Resource  -->
    <entry>
      <reference value="http://fhirtest.uhn.ca/baseDstu3/Observation/117689"/>
    </entry>
  </section>
</Composition>