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

<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="lipid"/>
  <contained>
    <Observation>
      <id value="fasting"/>
      <!--     the mandatory quality flag:     -->
      <status value="final"/>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="49541-6"/>
          <display value="Fasting status - Reported"/>
        </coding>
      </code>
      <subject>
        <reference value="Patient/example"/>
      </subject>
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0136"/>
          <code value="Y"/>
          <display value="Yes"/>
        </coding>
      </valueCodeableConcept>
    </Observation>
  </contained>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="PLAC"/>
      </coding>
      <text value="Placer"/>
    </type>
    <system value="urn:oid:1.3.4.5.6.7"/>
    <value value="2345234234234"/>
  </identifier>
  <status value="active"/>
  <intent value="original-order"/>
  <code>
    <concept>
      <coding>
        <system value="http://acme.org/tests"/>
        <code value="LIPID"/>
      </coding>
      <text value="Lipid Panel"/>
    </concept>
  </code>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <encounter>
    <reference value="Encounter/example"/>
  </encounter>
  <occurrenceDateTime value="2013-05-02T16:16:00-07:00"/>
  <requester>
    <reference value="Practitioner/example"/>
  </requester>
  <performer>
    <reference value="Practitioner/f202"/>
  </performer>
  <reason>
    <concept>
      <coding>
        <system value="http://hl7.org/fhir/sid/icd-9"/>
        <code value="V173"/>
        <display value="Fam hx-ischem heart dis"/>
      </coding>
    </concept>
  </reason>
  <supportingInfo>
    <reference>
      <reference value="#fasting"/>
      <display value="Fasting status"/>
    </reference>
  </supportingInfo>
  <note>
    <text value="patient is afraid of needles"/>
  </note>
</ServiceRequest>