<?xml version="1.0" encoding="UTF-8"?>

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="ft4"/>
  <status value="active"/>
  <intent value="reflex-order"/>
  <code>
    <concept>
      <coding>
        <system value="http://loinc.org"/>
        <code value="3024-7"/>
        <display value="Thyroxine (T4) free [Mass/volume] in Serum or Plasma"/>
      </coding>
      <text value="Free T4"/>
    </concept>
  </code>
  <subject>
    <reference value="Patient/pat2"/>
  </subject>
  <occurrenceDateTime value="2015-08-27T09:33:27+07:00"/>
  <requester>
    <reference value="Practitioner/example"/>
  </requester>
</ServiceRequest>