{
  "resourceType": "Questionnaire",
  "id": "f201",
  "text": {
    "status": "generated",
    "div": "\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\n      \n      \u003cpre\u003eLifelines Questionnaire 1 part 1\n  1. Do you have allergies?\n  2. General Questions:\n    2.a) What is your gender?\n    2.b) What is your date of birth?\n    2.c) What is your country of birth?\n    2.d) What is your marital status?\n    3. Intoxications:\n      3.a) Do you smoke?\n      3.b) Do you drink alcohol?\u003c/pre\u003e\n    \n    \u003c/div\u003e"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    }
  ],
  "url": "http://hl7.org/fhir/Questionnaire/f201",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.20.6"
    }
  ],
  "status": "active",
  "subjectType": [
    "Patient"
  ],
  "date": "2010",
  "publisher": "HL7 International / FHIR Infrastructure",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "code": [
    {
      "system": "http://example.org/system/code/lifelines/nl",
      "code": "VL 1-1, 18-65_1.2.2",
      "display": "Lifelines Questionnaire 1 part 1"
    }
  ],
  "item": [
    {
      "linkId": "1",
      "text": "Do you have allergies?",
      "type": "boolean"
    },
    {
      "linkId": "2",
      "text": "General questions",
      "type": "group",
      "item": [
        {
          "linkId": "2.1",
          "text": "What is your gender?",
          "type": "string"
        },
        {
          "linkId": "2.2",
          "text": "What is your date of birth?",
          "type": "date"
        },
        {
          "linkId": "2.3",
          "text": "What is your country of birth?",
          "type": "string"
        },
        {
          "linkId": "2.4",
          "text": "What is your marital status?",
          "type": "string"
        }
      ]
    },
    {
      "linkId": "3",
      "text": "Intoxications",
      "type": "group",
      "item": [
        {
          "linkId": "3.1",
          "text": "Do you smoke?",
          "type": "boolean"
        },
        {
          "linkId": "3.2",
          "text": "Do you drink alchohol?",
          "type": "boolean"
        }
      ]
    }
  ]
}