ViralHepatitisCaseReportFormModel
type: StructureDefinition
node role: treeRoot
id:
  v: ViralHepatitisCaseReportFormModel
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ViralHepatitisCaseReportFormModel Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> ViralHepatitisCaseReportFormModel 0..* Base VH Case Report Form Logical Model #xD; ConsultDate 1..1 dateTime Consult Date (MM/DD/YYYY) #xD; PatientCode 1..1 Identifier Patient Code #xD; TestingFacilityName 1..1 Reference() Testing Facility Name #xD; ContactNo 0..* ContactPoint Contact Number #xD; FacilityAddress 1..1 Address Facility Address #xD; ClientType 1..1 code Client Type #xD; TestedPositiveForHepatitisB 0..1 BackboneElement If patient tested positive for Hepatitis B #xD; TestedPositiveForHepatitisC 0..1 BackboneElement If patient tested positive for Hepatitis C #xD; DateofBaselineHBsAgTest 0..1 dateTime Date of Baseline HBsAgTest (MM/DD/YYYY) #xD; DateofBaselineAnti-HCVTest 0..1 dateTime Date of Baseline Anti-HCV test (MM/DD/YYYY) #xD; FirstName 0..* HumanName First Name #xD; MiddleName 0..* HumanName Middle Name #xD; LastName 1..1 HumanName Last Name #xD; Suffix 0..* HumanName Suffix #xD; UniqueIdentifierCode 1..1 id Unique Identifier Code for the patient #xD; FirstTwoLetterOfMothersName 1..1 id First two letters of mother's name #xD; FirstTwoLetterOfFathersName 1..1 id First two letters of father's name #xD; BirthOrder 1..1 integer Birth Order #xD; BirthDate 1..1 date Birth Date #xD; SexAssignedAtBirth 0..1 code Sex Assigned at Birth #xD; SelfIdentity 0..1 code Patient Self Identity #xD; IsShePregnant 0..* code If female, is she pregnant? #xD; IsShePregnant 0..* CodeableConcept If female, is she pregnant? #xD; NumberOfChildren 0..* integer Number of Children #xD; CivilStatus 0..* CodeableConcept Civil Status #xD; Nationality 0..* CodeableConcept Nationality #xD; AgeInYears 1..1 Age Age of Patient in Years #xD; PhilHealthNo 1..1 Identifier PhilHealth Number of the Patient #xD; CurrentAddressCityMunicipality 1..* Address Current City/Municipality Address of the Patient #xD…
url:
  v: http://worldhealthorganization.github.io/smart-ig-upvhproject/StructureDefinition/ViralHepatitisCaseReportFormModel
  l: ViralHepatitisCaseReportFormModel
version:
  v: 0.2.1
name:
  v: ViralHepatitisCaseReportFormModel
title:
  v: VH Case Report Form Logical Model
status:
  v: draft
date:
  v: 2026-02-06T04:39:10+00:00
publisher:
  v: UP Manila Viral Hepatitis Project
contact:
  name:
    v: UP Manila Viral Hepatitis Project
  telecom:
    system:
      v: url
    value:
      v: http://ehealth4hepatitis.ph
description:
  v: Viral Hepatitis Case Report Form Logical Model
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
fhir version:
  v: 4.0.1
kind:
  v: logical
abstract:
  v: false
type:
  v: http://worldhealthorganization.github.io/smart-ig-upvhproject/StructureDefinition/ViralHepatitisCaseReportFormModel
  l: ViralHepatitisCaseReportFormModel
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Base
  l: Base
derivation:
  v: specialization
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: ViralHepatitisCaseReportFormModel
    path:
      v: ViralHepatitisCaseReportFormModel
    short:
      v: VH Case Report Form Logical Model
    definition:
      v: Viral Hepatitis Case Report Form Logical Model
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Base
      min:
        v: 0
      max:
        v: *
    is modifier:
      v: false
  element:
    id:
      v: ViralHepatitisCaseReportFormModel.ConsultDate
    path:
      v: ViralHepatitisCaseReportFormModel.ConsultDate
    short:
      v: Consult Date (MM/DD/YYYY)
    definition:
      v: Consult Date (MM/DD/YYYY)
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: ViralHepatitisCaseReportFormModel.ConsultDate
      min:
        v: 1
      max:
        v: 1
    type:
      code:
        v: dateTime
        l: dateTime
  element:
    id:
      v: ViralHepatitisCaseReportFormModel.PatientCode
    path:
      v: ViralHepatitisCaseReportFormModel.PatientCode
    short:
      v: Patient Code
    definition:
      v: Patient Identifier
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: ViralHepatitisCaseReportFormModel.PatientCode
      min:
        v: 1
      max:
        v: 1
    type:
      code:
        v: Identifier
        l: Identifier
  element:
    id:
      v: ViralHepatitisCaseReportFormModel.TestingFacilityName
    path:
      v: ViralHepatitisCaseReportFormModel.TestingFacilityName
    short:
      v: Testing Facility Name
    definition:
      v: The location where the encounter takes place.
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: ViralHepatitisCaseReportFormModel.TestingFacilityName
      min:
        v: 1
      max:
        v: 1
    type:
      code:
        v: Reference
        l: Reference
  element:
    id:
      v: ViralHepatitisCaseReportFormModel.ContactNo
    path:
      v: ViralHepatitisCaseReportFormModel.ContactNo
    short:
      v: Contact Number
    definition:
      v: Contact number of the Patient
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: ViralHepatitisCaseReportFormModel.ContactNo
      min:
        v: 0
      max:
        v: *
    type:
      code:
        v: ContactPoint
        l: ContactPoint
  element:
    id:
      v: ViralHepatitisCaseReportFormModel.FacilityAddress
    path:
      v: ViralHepatitisCaseReportFormModel.FacilityAddress
    short:
      v: Facility Address
    definition:
      v: Physical location where the encounter takes place
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: ViralHepatitisCaseReportFormModel.FacilityAddress
      min:
        v: 1
      max:
        v: 1
    type:
      code:
        v: Address
        l: Address

id:
  v: ViralHepatitisCaseReportFormModel.ClientType
path:
  v: ViralHepatitisCaseReportFormModel.ClientType
short:
  v: Client Type
definition:
  v: Walk-in, Referrakm, and In-patient
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.ClientType
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisB
path:
  v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisB
short:
  v: If patient tested positive for Hepatitis B
definition:
  v: If patient tested positive for Hepatitis B
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisB
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisC
path:
  v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisC
short:
  v: If patient tested positive for Hepatitis C
definition:
  v: If patient tested positive for Hepatitis C
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.TestedPositiveForHepatitisC
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DateofBaselineHBsAgTest
path:
  v: ViralHepatitisCaseReportFormModel.DateofBaselineHBsAgTest
short:
  v: Date of Baseline HBsAgTest (MM/DD/YYYY)
definition:
  v: Date of Baseline HBsAgTest (MM/DD/YYYY)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.DateofBaselineHBsAgTest
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime

id:
  v: ViralHepatitisCaseReportFormModel.DateofBaselineAnti-HCVTest
path:
  v: ViralHepatitisCaseReportFormModel.DateofBaselineAnti-HCVTest
short:
  v: Date of Baseline Anti-HCV test (MM/DD/YYYY)
definition:
  v: Date of Baseline Anti-HCV test (MM/DD/YYYY)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.DateofBaselineAnti-HCVTest
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime

id:
  v: ViralHepatitisCaseReportFormModel.FirstName
path:
  v: ViralHepatitisCaseReportFormModel.FirstName
short:
  v: First Name
definition:
  v: First Name of the Patient
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.FirstName
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: HumanName
    l: HumanName

id:
  v: ViralHepatitisCaseReportFormModel.MiddleName
path:
  v: ViralHepatitisCaseReportFormModel.MiddleName
short:
  v: Middle Name
definition:
  v: Middle Name of the Patient
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.MiddleName
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: HumanName
    l: HumanName

id:
  v: ViralHepatitisCaseReportFormModel.LastName
path:
  v: ViralHepatitisCaseReportFormModel.LastName
short:
  v: Last Name
definition:
  v: Last Name of the Patient
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.LastName
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: HumanName
    l: HumanName

id:
  v: ViralHepatitisCaseReportFormModel.Suffix
path:
  v: ViralHepatitisCaseReportFormModel.Suffix
short:
  v: Suffix
definition:
  v: Suffix of the Patient
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.Suffix
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: HumanName
    l: HumanName

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode
short:
  v: Unique Identifier Code for the patient
definition:
  v: First two letters of mother's name, First two letters of father's name, birth order, and Birthdate (MM/FF/BO/MM/DD/YYYY)
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode
  min:
    v: 1
  max:
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type:
  code:
    v: id
    l: id
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.ViralHepatitisCaseReportFormModel.UniqueIdentifierCode
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.ViralHepatitisCaseReportFormModel.UniqueIdentifierCode
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
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type:
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    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.extension
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.value
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.value
representation:
  v: xmlAttr
short:
  v: Primitive value for id
definition:
  v: Primitive value for id
min:
  v: 0
max:
  v: 1
base:
  path:
    v: string.value
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    v: 0
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    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/regex
      l: regex
    value: String
      v: [A-Za-z0-9\-\.]{1,64}
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfMothersName
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfMothersName
short:
  v: First two letters of mother's name
definition:
  v: Format - AA/XX/XX/XX/XX/XXXX
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfMothersName
  min:
    v: 1
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type:
  code:
    v: id
    l: id

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfFathersName
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfFathersName
short:
  v: First two letters of father's name
definition:
  v: Format - XX/AA/XX/XX/XX/XXXX
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.FirstTwoLetterOfFathersName
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: id
    l: id

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthOrder
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthOrder
short:
  v: Birth Order
definition:
  v: Format - XX/XX/##/XX/XX/XXXX
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthOrder
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: integer
    l: integer

id:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthDate
path:
  v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthDate
short:
  v: Birth Date
definition:
  v: Format - XX/XX/XX/MM/DD/YYYY
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.UniqueIdentifierCode.BirthDate
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: date
    l: date

id:
  v: ViralHepatitisCaseReportFormModel.SexAssignedAtBirth
path:
  v: ViralHepatitisCaseReportFormModel.SexAssignedAtBirth
short:
  v: Sex Assigned at Birth
definition:
  v: Sex Assigned at Birth
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.SexAssignedAtBirth
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: ViralHepatitisCaseReportFormModel.SelfIdentity
path:
  v: ViralHepatitisCaseReportFormModel.SelfIdentity
short:
  v: Patient Self Identity
definition:
  v: Patient Self Identity
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ViralHepatitisCaseReportFormModel.SelfIdentity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code

id:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant
path:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant
short:
  v: If female, is she pregnant?
definition:
  v: If female, is she pregnant?
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.IsShePregnant
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    v: 0
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type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element

id:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.id
path:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.id
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references)
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
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    v: 0
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type:
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    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
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    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.extension
path:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
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type:
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constraint:
  key:
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
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  human:
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    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.value
path:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.value
representation:
  v: xmlAttr
short:
  v: Primitive value for code
definition:
  v: Primitive value for code
min:
  v: 0
max:
  v: 1
base:
  path:
    v: string.value
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type:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/regex
      l: regex
    value: String
      v: [^\s]+(\s[^\s]+)*
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false

id:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.IsShePregnant
path:
  v: ViralHepatitisCaseReportFormModel.IsShePregnant.IsShePregnant
short:
  v: If female, is she pregnant?
definition:
  v: If female, is she pregnant?
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.IsShePregnant.IsShePregnant
  min:
    v: 0
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    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.NumberOfChildren
path:
  v: ViralHepatitisCaseReportFormModel.NumberOfChildren
short:
  v: Number of Children
definition:
  v: Number of Children
min:
  v: 0
max:
  v: *
base:
  path:
    v: ViralHepatitisCaseReportFormModel.NumberOfChildren
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: integer
    l: integer

id:
  v: ViralHepatitisCaseReportFormModel.CivilStatus
path:
  v: ViralHepatitisCaseReportFormModel.CivilStatus
short:
  v: Civil Status
definition:
  v: Civil Status
min:
  v: 0
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id:
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path:
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id:
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path:
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short:
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definition:
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id:
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id:
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id:
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short:
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id:
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id:
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comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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path:
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short:
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definition:
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comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
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mapping:
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id:
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path:
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short:
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element:
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v: 0

v: *

code:
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id:
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id:
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definition:
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id:
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path:
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type:
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path:
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definition:
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type:
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id:
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definition:
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type:
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id:
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path:
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definition:
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id:
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path:
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short:
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definition:
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id:
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path:
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definition:
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id:
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short:
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definition:
  v: If female, is she pregnant?
min:
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type:
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    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.NumberOfChildren
path:
  v: ViralHepatitisCaseReportFormModel.NumberOfChildren
short:
  v: Number of Children
definition:
  v: Number of Children
min:
  v: 0
max:
  v: *
type:
  code:
    v: integer
    l: integer

id:
  v: ViralHepatitisCaseReportFormModel.CivilStatus
path:
  v: ViralHepatitisCaseReportFormModel.CivilStatus
short:
  v: Civil Status
definition:
  v: Civil Status
min:
  v: 0
max:
  v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.Nationality
path:
  v: ViralHepatitisCaseReportFormModel.Nationality
short:
  v: Nationality
definition:
  v: Nationality
min:
  v: 0
max:
  v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.AgeInYears
path:
  v: ViralHepatitisCaseReportFormModel.AgeInYears
short:
  v: Age of Patient in Years
definition:
  v: Age of Patient in Years
min:
  v: 1
max:
  v: 1
type:
  code:
    v: Age
    l: Age

id:
  v: ViralHepatitisCaseReportFormModel.PhilHealthNo
path:
  v: ViralHepatitisCaseReportFormModel.PhilHealthNo
short:
  v: PhilHealth Number of the Patient
definition:
  v: PhilHealth Number of the Patient
min:
  v: 1
max:
  v: 1
type:
  code:
    v: Identifier
    l: Identifier

id:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressCityMunicipality
path:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressCityMunicipality
short:
  v: Current City/Municipality Address of the Patient
definition:
  v: Current City/Municipality Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressProvince
path:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressProvince
short:
  v: Current Province Address of the Patient
definition:
  v: Current Province Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressRegion
path:
  v: ViralHepatitisCaseReportFormModel.CurrentAddressRegion
short:
  v: Current Region Address of the Patient
definition:
  v: Current Region Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressCityMunicipality
path:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressCityMunicipality
short:
  v: Permanent City/Municipality Address of the Patient
definition:
  v: Permanent City/Municipality Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressProvince
path:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressProvince
short:
  v: Permanent Province Address of the Patient
definition:
  v: Permanent Province Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressRegion
path:
  v: ViralHepatitisCaseReportFormModel.PermanentAddressRegion
short:
  v: Permanent Region Address of the Patient
definition:
  v: Permanent Region Address of the Patient
min:
  v: 1
max:
  v: *
type:
  code:
    v: Address
    l: Address

id:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsMotherTestPositiveForHepatitisB
path:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsMotherTestPositiveForHepatitisB
short:
  v: History of Client's mother for Hepatitis B
definition:
  v: Did the client's mother test positive for Hepatitis B?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsMotherTestPositiveForHepatitisC
path:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsMotherTestPositiveForHepatitisC
short:
  v: History of Client's mother for Hepatitis C
definition:
  v: Did the client's mother test positive for Hepatitis C?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB
path:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsSpouseOrPartnerTestPositiveForHepatitisB
short:
  v: History of Client's Spouse/Partner for Hepatitis B
definition:
  v: Did the client's spouse/partner test positive for Hepatitis B?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC
path:
  v: ViralHepatitisCaseReportFormModel.DidTheClientsSpouseOrPartnerTestPositiveForHepatitisC
short:
  v: History of Client's Spouse/Partner for Hepatitis C
definition:
  v: Did the client's spouse/partner test positive for Hepatitis C?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfSharingNeedleAndOrSyringeWithOthers
short:
  v: History of client of using/sharing needle or syringe with others
definition:
  v: Does the client have history of sharing needle and/or syringe with others?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfInjectingDrugs
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfInjectingDrugs
short:
  v: Does the client have history of injecting drugs?
definition:
  v: Does the client have history of injecting drugs?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood
path:
  v: ViralHepatitisCaseReportFormModel.HasTheClientBeenAccidentallyPrickedByObjectContaminatedWithBlood
short:
  v: Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
definition:
  v: Has the client been accidentally pricked by needles/sharps or other objects contaminated with blood?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DidTheClientReceiveATattoo
path:
  v: ViralHepatitisCaseReportFormModel.DidTheClientReceiveATattoo
short:
  v: Did the client receive a tattoo?
definition:
  v: Did the client receive a tattoo?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale
path:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryInThePastYearOfSexualIntercourseWithAMale
short:
  v: Was there a history(past year) of sexual intercourse with a male?
definition:
  v: Was there a history(past year) of sexual intercourse with a male?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale
path:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryInThePastYearOfSexualIntercourseWithAFemale
short:
  v: Was there a history(past year) of sexual intercourse with a female?
definition:
  v: Was there a history(past year) of sexual intercourse with a female?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientPayInCashOrInKindForSex
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientPayInCashOrInKindForSex
short:
  v: Does the client pay (in cash or in kind) for sex?
definition:
  v: Does the client pay (in cash or in kind) for sex?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientAcceptPaymentInCashOrInKindInExchangeForSex
short:
  v: Does the client accept payment (in cash or in kind) in exchange for sex?
definition:
  v: Does the client accept payment (in cash or in kind) in exchange for sex?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfEmploymentAbroadInThePast
path:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfEmploymentAbroadInThePast
short:
  v: Was there a history of employment abroad in the past?
definition:
  v: Was there a history of employment abroad in the past?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer
path:
  v: ViralHepatitisCaseReportFormModel.IsThereAFamilyHistoryOfHCCOrPrimaryLiverCancer
short:
  v: History of Client's family on Hepatocellular Carcinoma (HCC)/Primary Liver Cancer
definition:
  v: Is there a family history of Hepatocellular Carcinoma (HCC)/primary liver cancer?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHCCPriorToHepatitisBAndOrHepatitisCDiagnosis
short:
  v: Client's History of having Hepatocellular Carcinoma
definition:
  v: Does the client have hepatocellular carcinoma prior to Hepatitis B and/or Hepatitis C diagnosis?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfReceivingBloodOrBloodProducts
short:
  v: Client's History of Receiving Blood or Blood Products
definition:
  v: Does the client have history of receiving blood/blood products?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfUndergoingHemodialysis
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfUndergoingHemodialysis
short:
  v: Client's History of undergoing hemodialysis
definition:
  v: Does the client have history of undergoing hemodialysis?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfBeingVaccinatedForHepatitisA
path:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfBeingVaccinatedForHepatitisA
short:
  v: Client's History of Being Vaccinated for Hepatitis A
definition:
  v: Was there a history of being vaccinated for Hepatitis A?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfBeingVaccinatedForHepatitisB
path:
  v: ViralHepatitisCaseReportFormModel.WasThereAHistoryOfBeingVaccinatedForHepatitisB
short:
  v: Client's History of Being Vaccinated for Hepatitis B
definition:
  v: Was there a history of being vaccinated for Hepatitis B?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment
path:
  v: ViralHepatitisCaseReportFormModel.DoesTheClientHaveHistoryOfHIVTreatmentPriorToEnrollment
short:
  v: Client's History of Undergoing HIV Treatment Prior to Enrollment
definition:
  v: Does the client have history of HIV treatment prior to enrollment?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept

id:
  v: ViralHepatitisCaseReportFormModel.HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV
path:
  v: ViralHepatitisCaseReportFormModel.HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV
short:
  v: The Client has history of testing positive for HIV prior to the baseline diagnosis of viral hepatitis
definition:
  v: Did the client tested positive for HIV prior to baseline diagnosis of hepatitis?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV.NoYesHIVMedsTaken
path:
  v: ViralHepatitisCaseReportFormModel.HIVIfTheClientHasHistoryOfTakingAntiretroviralDrugForHIV.NoYesHIVMedsTaken
short:
  v: List of Antiretroviral Drugs for HIV Taken
definition:
  v: If the client has history of taking antiretroviral drugs, please specify the drug(s) used
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB
path:
  v: ViralHepatitisCaseReportFormModel.HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB
short:
  v: The Client has history of testing positive for Hepatitis B prior to the baseline diagnosis of viral hepatitis
definition:
  v: Did the client tested positive for Hepatitis B prior to baseline diagnosis of hepatitis?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB.NoYesHepatitisBMedsTaken
path:
  v: ViralHepatitisCaseReportFormModel.HepatitisBIfTheClientHasHistoryOfTakingAntiviralDrugForHepB.NoYesHepatitisBMedsTaken
short:
  v: List of Antiviral Drugs for Hepatitis B Taken
definition:
  v: If the client has history of taking antiviral drugs for Hepatitis B, please specify the drug(s) used
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC
path:
  v: ViralHepatitisCaseReportFormModel.HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC
short:
  v: The Client has history of testing positive for Hepatitis C prior to the baseline diagnosis of viral hepatitis
definition:
  v: Did the client tested positive for Hepatitis C prior to baseline diagnosis of hepatitis?
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement

id:
  v: ViralHepatitisCaseReportFormModel.HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC.NoYesHepatitisCMedsTaken
path:
  v: ViralHepatitisCaseReportFormModel.HepatitisCIfTheClientHasHistoryOfTakingAntiviralDrugForHepC.NoYesHepatitisCMedsTaken
short:
  v: List of Antiviral Drugs for Hepatitis C Taken
definition:
  v: If the client has history of taking antiviral drugs for Hepatitis C, please specify the drug(s) used
min:
  v: 1
max:
  v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement