<ServiceRequest xmlns="http://hl7.org/fhir"><id value="ft4"/><status value="active"/><intent value="reflex-order"/><code><concept><coding><system value="http://loinc.org"/><code value="3024-7"/><display value="Thyroxine (T4) free [Mass/volume] in Serum or Plasma"/></coding><text value="Free T4"/></concept></code><subject><reference value="Patient/pat2"/></subject><occurrenceDateTime value="2015-08-27T09:33:27+07:00"/><requester><reference value="Practitioner/example"/></requester></ServiceRequest>