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  <meta>
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      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
      <img alt="Family history diagram for Annie Proband" src="#image"/>
    </div>
  </text>
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      <id value="image"/>
      <contentType value="image/png"/>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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          <display value="self"/>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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            <display value="Ovarian Carcinoma"/>
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            <coding>
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              <display value="natural father"/>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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      <name value="Donald"/>
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          <display value="natural father"/>
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  <contained>
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      <id value="4"/>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <name value="Gladys"/>
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          <display value="maternal grandmother"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
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        <code>
          <coding>
            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C4872"/>
            <display value="Breast Carcinoma"/>
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          <unit value="years"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="a"/>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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  <contained>
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      <id value="6"/>
      <status value="completed"/>
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        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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          <code value="PGRMTH"/>
          <display value="paternal grandmother"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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          <coding>
            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C2955"/>
            <display value="Colorectal Carcinoma"/>
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          <unit value="years"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="a"/>
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        <extension url="type">
          <valueCodeableConcept>
            <coding>
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              <code value="NMTH"/>
              <display value="natural mother"/>
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        <extension url="type">
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              <code value="NFTH"/>
              <display value="natural father"/>
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          </valueCodeableConcept>
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            <reference value="#3"/>
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      <status value="completed"/>
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        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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      <name value="Brian"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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        <code>
          <coding>
            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C2955"/>
            <display value="Rectal Carcinoma"/>
          </coding>
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          <unit value="years"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="a"/>
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        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#2"/>
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        <extension url="type">
          <valueCodeableConcept>
            <coding>
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              <code value="NFTH"/>
              <display value="natural father"/>
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        <extension url="reference">
          <valueReference>
            <reference value="#3"/>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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      <name value="Janet"/>
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          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="NSIS"/>
          <display value="natural sister"/>
        </coding>
      </relationship>
      <!-- Age was 31 in source, but 36 in diagram -->
      <ageAge>
        <value value="36"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C2924"/>
            <display value="Ductal Carcinoma In Situ of the Breast"/>
          </coding>
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          <unit value="years"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="a"/>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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          <code value="BROINLAW"/>
          <display value="brother-in-law"/>
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      <ageAge>
        <value value="30"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
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        <extension url="reference">
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
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      <status value="completed"/>
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        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="NEPHEW"/>
          <display value="Nephew"/>
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      <ageAge>
        <value value="16"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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        <extension url="type">
          <valueCodeableConcept>
            <coding>
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              <code value="NMTH"/>
              <display value="natural mother"/>
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        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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      <name value="Helen"/>
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          <display value="niece"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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      <condition>
        <code>
          <coding>
            <!-- No system or OID for NCBI Entrez yet -->
            <code value="657"/>
            <display value="BRCA2"/>
          </coding>
          <coding>
            <system value="urn:oid:2.16.840.1.113883.6.133"/>
            <code value="1101"/>
            <display value="BRCA2"/>
          </coding>
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      <status value="completed"/>
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        <display value="Annie Proband, female, born 1966"/>
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          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
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          <display value="significant other"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
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          </valueCodeableConcept>
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
            </coding>
          </valueCodeableConcept>
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        <extension url="reference">
          <valueReference>
            <reference value="#13"/>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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      <name value="Susan"/>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
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          <display value="natural daughter"/>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
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              <display value="natural mother"/>
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            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
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          </valueCodeableConcept>
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        <extension url="reference">
          <valueReference>
            <reference value="#7"/>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="PUNCLE"/>
          <display value="paternal uncle"/>
        </coding>
      </relationship>
      <ageAge>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
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  <contained>
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            <coding>
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              <display value="natural mother"/>
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        <extension url="reference">
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      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
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          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
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        <extension url="reference">
          <valueReference>
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      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
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          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
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          <display value="paternal aunt"/>
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      <ageAge>
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        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
      <condition>
        <code>
          <coding>
            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C3224"/>
            <display value="Melanoma"/>
          </coding>
        </code>
      </condition>
    </FamilyMemberHistory>
  </contained>
  <contained>
    <FamilyMemberHistory>
      <id value="17"/>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#4"/>
          </valueReference>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#5"/>
          </valueReference>
        </extension>
      </extension>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="MUNCLE"/>
          <display value="maternal uncle"/>
        </coding>
      </relationship>
      <ageAge>
        <value value="60"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
    </FamilyMemberHistory>
  </contained>
  <contained>
    <FamilyMemberHistory>
      <id value="18"/>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#4"/>
          </valueReference>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#5"/>
          </valueReference>
        </extension>
      </extension>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="MAUNT"/>
          <display value="maternal aunt"/>
        </coding>
      </relationship>
      <ageAge>
        <value value="57"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
    </FamilyMemberHistory>
  </contained>
  <contained>
    <FamilyMemberHistory>
      <id value="19"/>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="EXT"/>
          <display value="extended family member"/>
        </coding>
      </relationship>
    </FamilyMemberHistory>
  </contained>
  <contained>
    <FamilyMemberHistory>
      <id value="20"/>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#18"/>
          </valueReference>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#19"/>
          </valueReference>
        </extension>
      </extension>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="MCOUSN"/>
          <display value="maternal cousin"/>
        </coding>
      </relationship>
      <sex>
        <coding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="female"/>
          <display value="Female"/>
        </coding>
      </sex>
      <ageAge>
        <value value="30"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
      <condition>
        <code>
          <coding>
            <system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
            <code value="C4872"/>
            <display value="Breast Carcinoma"/>
          </coding>
        </code>
        <onsetAge>
          <value value="30"/>
          <unit value="years"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="a"/>
        </onsetAge>
      </condition>
    </FamilyMemberHistory>
  </contained>
  <contained>
    <FamilyMemberHistory>
      <id value="21"/>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NMTH"/>
              <display value="natural mother"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#18"/>
          </valueReference>
        </extension>
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/family-member-history-genetics-parent">
        <extension url="type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="NFTH"/>
              <display value="natural father"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension url="reference">
          <valueReference>
            <reference value="#19"/>
          </valueReference>
        </extension>
      </extension>
      <status value="completed"/>
      <patient>
        <reference value="Patient/proband"/>
        <display value="Annie Proband, female, born 1966"/>
      </patient>
      <relationship>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
          <code value="MCOUSN"/>
          <display value="maternal cousin"/>
        </coding>
      </relationship>
      <sex>
        <coding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="female"/>
          <display value="Female"/>
        </coding>
      </sex>
      <ageAge>
        <value value="31"/>
        <unit value="years"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
      </ageAge>
    </FamilyMemberHistory>
  </contained>
  <status value="current"/>
  <mode value="snapshot"/>
  <code>
    <coding>
      <system value="http://loinc.org"/>
      <code value="8670-2"/>
      <display value="History of family member diseases"/>
    </coding>
  </code>
  <!-- Age said 33, but diagram shows 42, so adjusted DOB -->
  <subject>
    <reference value="Patient/proband"/>
    <display value="Annie Proband, female, born 1966"/>
  </subject>
  <entry>
    <item>
      <reference value="#image"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#2"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#3"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#4"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#5"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#6"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#7"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#8"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#9"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#10"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#11"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#12"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#13"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#14"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#15"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#16"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#17"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#18"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#19"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#20"/>
    </item>
  </entry>
  <entry>
    <item>
      <reference value="#21"/>
    </item>
  </entry>
</List>