Vital Records Death Reporting FHIR Implementation Guide - Local Development build (v1.1.0). See the Directory of published versions
<Patient xmlns="http://hl7.org/fhir">
<id value="51b806c8-566f-463e-8783-9fbf6be8161d"/>
<meta>
<versionId value="6"/>
<lastUpdated value="2021-08-18T12:13:30.341+00:00"/>
<source value="#EA5PrKCCVEwaBe1B"/>
<profile
value="http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Decedent"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><div class="hapiHeaderText">Example Something Middle
<b>LAST </b> Jr.
</div><table class="hapiPropertyTable"><tbody><tr><td>Identifier</td><td>123456789</td></tr><tr><td>Address</td><td><span>101 Example Street </span><br/><span>Line 2 </span><br/><span>Bedford </span><span>MA </span><span>United States </span></td></tr><tr><td>Date of birth</td><td><span>24 February Unknown Year</span></td></tr></tbody></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="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<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="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2028-9"/>
<display value="Asian"/>
</valueCoding>
</extension>
<extension url="detailed">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="1586-7"/>
<display value="Shoshone"/>
</valueCoding>
</extension>
<extension url="detailed">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2036-2"/>
<display value="Filipino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Mixed"/>
</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="2135-2"/>
<display value="Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="detailed">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2184-0"/>
<display value="Dominican"/>
</valueCoding>
</extension>
<extension url="detailed">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2148-5"/>
<display value="Mexican"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="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>
<line value="101 Example Birth Street"/>
<city value="12345"/>
<district value="13121"/>
<state value="UNK"/>
<postalCode value="01730"/>
<country value="US"/>
</valueAddress>
</extension>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SB"/>
<display value="Social Beneficiary Identifier"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="123456789"/>
</identifier>
<name>
<use value="official"/>
<family value="Last"/>
<given value="Example"/>
<given value="Something"/>
<given value="Middle"/>
<suffix value="Jr."/>
</name>
<name>
<use value="nickname"/>
<family value="LastNameAlias"/>
<given value="FirstNameAlias"/>
<given value="MiddleAlias"/>
<suffix value="Jr."/>
</name>
<gender value="male"/>
<birthDate>
<extension
url="http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Partial-date-part-absent-reason">
<extension url="year-absent-reason">
<valueCode value="asked-unknown"/>
</extension>
<extension url="date-month">
<valueInteger value="2"/>
</extension>
<extension url="date-day">
<valueInteger value="24"/>
</extension>
</extension>
</birthDate>
<address>
<extension
url="http://hl7.org/fhir/us/vrdr/StructureDefinition/Within-City-Limits-Indicator">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0136"/>
<code value="N"/>
<display value="No"/>
</valueCoding>
</extension>
<line value="101 Example Residence Street"/>
<line value="Line 2"/>
<city value="54321"/>
<district value="OTH"/>
<state value="MA"/>
<postalCode value="01730"/>
<country value="US"/>
</address>
<maritalStatus>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="S"/>
<display value="Never Married"/>
</coding>
</maritalStatus>
</Patient>