Birth And Fetal Death (BFDR) - STU2-ballot
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Birth And Fetal Death (BFDR) - STU2-ballot, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions

Example QuestionnaireResponse: QuestionnaireResponse - Patient's Fetal Death Worksheet: Carmen Lee

Generated Narrative: QuestionnaireResponse QuestionnaireResponse-patients-fetal-death-carmen-lee

LinkIDTextDefinitionAnswerdoco
.. QuestionnaireResponse-patients-fetal-death-carmen-leeQuestionnaire:Questionnaire - Patient's Worksheet for the Report of Fetal Death
... mother-current-legal-nameWhat is your current legal name?
.... mother-first-nameFirstCarmen
.... mother-middle-nameMiddleTeresa
.... mother-last-nameLastLee
... mother-addressWhere do you usually live - that is - where is your household/residence located?
.... mother-nbr-streetComplete number and street (do not enter rural route numbers)3670 Miller Road
.... mother-cityCity, Town, or Location
.... mother-stateState (or U.S. Territory, Canadian Province)MI
.... mother-zipZip Code48103
... inside-city-limitsIs this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?v2 Y/N Indicator N: No
... mother-mailWhat is your mailing address
.... mother-mail-sameSame as residence [Go to next question]true
... mother-dobWhat is your date of birth?1986-02-15
... mother-birthplaceIn what State, U.S. territory, or foreign country were you born? Please specify one of the following:
.... mother-birthplace-territoryor U.S. territory, i.e., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa or Norther MarianasPR
... mother-educationWhat is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).Education Level SEC: Some secondary or high school education
... mother-ethnicitytrue
... mother-ethnicity-mexicantrue
... mother-ethnicity-puerto-ricantrue
... mother-ethnicity-cubantrue
... mother-ethnicity-otherfalse
... mother-race
.... mother-race-black-or-aatrue
... father-current-legal-nameWhat is the current legal name of your baby's father?
.... father-first-nameFirstTom
.... father-middle-nameMiddleYan
.... father-last-nameLastLee
... father-dobWhat is the father's date of birth?1984-02-27
... father-birthplaceIn what State, U.S. territory, or foreign country was the father born? Please specify one of the following:
.... father-birthplace-stateStateNY
... receive-wicDid you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?v2 Y/N Indicator N: No
... mothers-heightWhat is your height?
.... mothers-height-inchesInches65 [in_i] (Details: UCUM code[in_i] = '[in_i]')
... mothers-prepregnancy-weightlbs180 [lb_av] (Details: UCUM code[lb_av] = '[lb_av]')
... mothers-smokingHow many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.
.... mothers-smoking-3-months-priorThree months before pregnancy
..... mothers-smoking-3-months-prior-cig# of cigarettes*0
..... mothers-smoking-3-months-prior-pck# of packs0
.... mothers-smoking-trimester-1First three months of pregnancy
..... mothers-smoking-trimester-1-cig# of cigarettes*0
..... mothers-smoking-trimester-1-pck# of packs0
.... mothers-smoking-trimester-2Second three months of pregnancy
..... mothers-smoking-trimester-2-cig# of cigarettes*0
..... mothers-smoking-trimester-2-pck# of packs0
.... mothers-smoking-trimester-3Third trimester of pregnancy
..... mothers-smoking-trimester-3-cig# of cigarettes*0
..... mothers-smoking-trimester-3-pck# of packs0

doco Documentation for this format