<Provenance xmlns="http://hl7.org/fhir"><id value="example-import"/><target><reference value="Condition/example"/></target><target><reference value="Condition/example2"/></target><target><reference value="Encounter/example"/></target><target><reference value="Immunization/example"/></target><recorded value="2015-06-27T08:39:24+10:00"/><policy value="urn:ihe:pcc:qedm:2017:document-provenance-policy"/><activity><coding><system value="http://hl7.org/fhir/w3c-provenance-activity-type"/><code value="Derivation"/></coding></activity><patient><reference value="Patient/example"/></patient><agent id="a1"><type><coding><system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/><code value="assembler"/></coding></type><who><display value="Device/software"/></who></agent><entity><role value="source"/><what><reference value="DocumentReference/example"/></what></entity></Provenance>