Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2 United States of America flag

Birth And Fetal Death (BFDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0 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

Table of Contents

.. 0 Table of Contents
... 1 Birth and Fetal Death Reporting Home
... 2 Content Transitions
... 3 Data Dictionary Natality
... 4 Data Dictionary Fetal Death
... 5 Appendices
... 6 Facility Worksheet for Live Birth
... 7 Example Live Birth Certificate
... 8 Facility Worksheet for Fetal Death
... 9 Example Fetal Death Report
... 10 Change Log
... 11 Patient Worksheet Questionnaires
... 12 Specification
... 13 Use Cases
... 14 Vital Records Form Mapping
... 15 Mapping Electronic Health Record Data to the Birth and Fetal Death Record Data Elements
... 16 Downloads
... 17 FHIR Implementation Guide Harmonization Plan
... 18 Usage
... 19 Use of Categories
... 20 Live Birth Report Example - Baby G Quinn
... 21 Fetal Death Report Example - Not Named
... 22 Credits
... 23 Artifacts Summary
.... 23.1 CapabilityStatement - Birth and Fetal Death
.... 23.2 Bundle - Document Birth Report
.... 23.3 Bundle - Document Fetal Death Report
.... 23.4 Bundle - Document Demographic Coded Content
.... 23.5 Bundle - Document Coded Cause of Fetal Death
.... 23.6 Bundle - Document Coded Industry and Occupation
.... 23.7 Composition - Provider Fetal Death Report
.... 23.8 Composition - Provider Live Birth Report
.... 23.9 Composition - Jurisdiction Fetal Death Report
.... 23.10 Composition - Jurisdiction Live Birth Report
.... 23.11 Composition - Coded Cause of Fetal Death
.... 23.12 Composition - Coded Race and Ethnicity
.... 23.13 Composition - Coded Industry and Occupation
.... 23.14 Questionnaire - Mother's Worksheet for Child's Birth Certificate
.... 23.15 Questionnaire - Patient's Fetal Death Worksheet
.... 23.16 Encounter - Birth
.... 23.17 Encounter - Maternity
.... 23.18 Birth and Fetal Death Location
.... 23.19 Jurisdictional Facility Identifier
.... 23.20 Encounter Maternity Reference
.... 23.21 Practitioner - Birth Attendant
.... 23.22 Practitioner - Birth Certifier
.... 23.23 Practitioner Role - Birth Attendant
.... 23.24 Practitioner Role - Certifier
.... 23.25 Observation - APGAR Score
.... 23.26 Observation - Birth Weight
.... 23.27 Observation - Fetal Presentation at Birth/Delivery
.... 23.28 Observation - Gestational Age at Delivery
.... 23.29 Observation - Infant Breastfed at Discharge
.... 23.30 Observation - Infant Living
.... 23.31 Observation - Mother Delivery Weight (reported in pounds)
.... 23.32 Observation - Number of Fetal Deaths This Delivery
.... 23.33 Observation - Number of Live Births This Delivery
.... 23.34 Condition - Seizure
.... 23.35 Observation - NICU Admission
.... 23.36 Procedure - Antibiotic for Suspected Neonatal Sepsis
.... 23.37 Procedure - Assisted Ventilation Following Delivery
.... 23.38 Procedure - Assisted Ventilation More Than Six Hours
.... 23.39 Procedure - Surfactant Replacement Therapy
.... 23.40 Observation - None Of Specified Abnormal Conditions of Newborn
.... 23.41 Condition - Congenital Anomaly of Newborn
.... 23.42 Observation - None Of Specified Congenital Anomolies Of The Newborn
.... 23.43 Condition - Chorioamnionitis
.... 23.44 Observation - Antibiotics Administered During Labor
.... 23.45 Observation - Administration of Steroids for Fetal Lung Maturation
.... 23.46 Procedure - Augmentation of Labor
.... 23.47 Procedure - Epidural or Spinal Anesthesia
.... 23.48 Procedure - Induction of Labor
.... 23.49 Observation - None Of Specified Characteristics of Labor and Delivery
.... 23.50 Coverage - Principal Payer for Delivery
.... 23.51 Observation - Cigarette Smoking Before and During Pregnancy
.... 23.52 Observation - Date of First Prenatal Care Visit
.... 23.53 Observation - Date of Last Live Birth
.... 23.54 Observation - Date of Last Other Pregnancy Outcome
.... 23.55 Observation - Last Menstrual Period
.... 23.56 Observation - Mother Height
.... 23.57 Observation - Mother Prepregnancy Weight
.... 23.58 Observation - Mother Recieved WIC Food
.... 23.59 Observation - Number of Births Now Dead
.... 23.60 Observation - Number of Births Now Living
.... 23.61 Observation - Number of Other Pregnancy Outcomes
.... 23.62 Observation - Number of Prenatal Visits
.... 23.63 Condition - Infection Present During Pregnancy
.... 23.64 Observation - None Of Specified Infections During Pregnancy
.... 23.65 Observation - Labor Trial Attempted
.... 23.66 Observation - Number of Previous Cesareans
.... 23.67 Procedure - Obstetric
.... 23.68 Observation - None Of Specified Obstetric Procedures
.... 23.69 Procedure - Final Route and Method of Delivery
.... 23.70 Observation - Unknown Final Route and Method of Delivery
.... 23.71 Condition - Eclampsia Hypertension
.... 23.72 Condition - Gestational Diabetes
.... 23.73 Condition - Gestational Hypertension
.... 23.74 Condition - Prepregnancy Diabetes
.... 23.75 Condition - Prepregnancy Hypertension
.... 23.76 Observation - Previous Cesarean
.... 23.77 Observation - Previous Preterm Birth
.... 23.78 Procedure - Fertility Enhancing Drug Therapy, Artificial or Intrauterine Insemination
.... 23.79 Procedure - Assisted Reproductive Technology
.... 23.80 Procedure - Infertility Treatment
.... 23.81 Observation - None Of Specified Pregnancy Risk Factors
.... 23.82 Condition - Perineal Laceration
.... 23.83 Condition - Ruptured Uterus
.... 23.84 Observation - ICU Admission
.... 23.85 Procedure - Blood Transfusion
.... 23.86 Procedure - Unplanned Hysterectomy
.... 23.87 Observation - None Of Specified Maternal Morbidities
.... 23.88 Condition - Fetal Death Initiating Cause or Condition
.... 23.89 Condition - Fetal Death Other Cause or Condition
.... 23.90 Observation - Autopsy Performed Indicator
.... 23.91 Observation - Autopsy or Histological Exam Results Used
.... 23.92 Observation - Fetal Death Time Point
.... 23.93 Observation - Fetal Remains Disposition Method
.... 23.94 Observation - Histological Placental Exam Performed
.... 23.95 Patient - Decedent Fetus
.... 23.96 Observation - Mother Married During Pregnancy
.... 23.97 Observation - Paternity Acknowledgement Signed
.... 23.98 Observation - Social Security Number Requested For Child
.... 23.99 Extension Parental Role
.... 23.100 Observation - Present Job
.... 23.101 Observation - Birth Plurality of Pregnancy
.... 23.102 Observation - Planned to Deliver at Home
.... 23.103 Observation - Coded Initiating Fetal Death Cause or Condition
.... 23.104 Observation - Coded Other Fetal Death Cause or Condition
.... 23.105 Birth Edit Flags
.... 23.106 Local BFDR Codes
.... 23.107 APGAR Score Timing
.... 23.108 Birth and Fetal Death Financial Class
.... 23.109 Birth Attendants Titles
.... 23.110 Birth Delivery Occurred
.... 23.111 Birth Weight Edit Flags (NCHS)
.... 23.112 Cigarette Smoking Before and During Pregnancy
.... 23.113 Delivery Routes
.... 23.114 Estimate of Gestation Edit Flags (NCHS)
.... 23.115 Fetal Death Cause or Condition
.... 23.116 Fetal Death Time Points
.... 23.117 Fetal Presentations
.... 23.118 Fetal Remains Disposition Method
.... 23.119 Performed NotPerformed Planned
.... 23.120 Infections During Pregnancy Live Birth
.... 23.121 Informant Relationship to Mother
.... 23.122 Location Types
.... 23.123 Fetal Presentations - Max
.... 23.124 Newborn Congenital Anomalies
.... 23.125 Number of Previous Cesareans Edit Flags (NCHS)
.... 23.126 Pregnancy Report Edit Flags (NCHS)
.... 23.127 Obstetric Procedure Outcome
.... 23.128 Units of Gestational Age
.... 23.129 Fertility Enhancing Drug Therapy and Artificial Insemination Value Set
.... 23.130 BirthAndFetalDeathFinancialClass Concept Map
.... 23.131 BirthAttendantTitles Concept Map
.... 23.132 BirthDeliveryOccurred Concept Map
.... 23.133 BirthWeightEditFlags Concept Map
.... 23.134 DeliveryRoutes Concept Map
.... 23.135 EstimateOfGestationEditFlags Concept Map
.... 23.136 FetalDeathCauseOrCondition Concept Map
.... 23.137 FetalDeathTimePoints Concept Map
.... 23.138 FetalPresentation Concept Map
.... 23.139 InfectionsDuringPregnancyLiveBirth Concept Map
.... 23.140 NewbornCongenitalAnomalies Concept Map
.... 23.141 NumberPreviousCesareansEditFlags Concept Map
.... 23.142 PerformedNotPerformedPlanned Concept Map
.... 23.143 PregnancyReportEditFlags Concept Map
.... 23.144 USA SNOMED-CT
.... 23.145 Bundle - Coded Cause of Fetal Death - not named
.... 23.146 Bundle - Jurisdiction Fetal Death Report - Fetus Not Named
.... 23.147 Bundle - Provider Fetal Death Report - Fetus Not Named
.... 23.148 Composition - Jurisdiction Fetal Death Report - Fetus Not Named
.... 23.149 Composition - Coded Cause of Fetal Death - Fetus Not Named
.... 23.150 Composition - Provider Fetal Death Report - Fetus Not Named
.... 23.151 Condition - Fetal Death Initiating Cause or Condition - Fetus Not Named
.... 23.152 Condition - Fetal Death Other Cause or Condition - Fetus Not Named
.... 23.153 Condition - Gestational Diabetes - Carmen Teresa Lee
.... 23.154 Encounter - Maternity - Carmen Teresa Lee
.... 23.155 Observation - Autopsy or Histological Exam Results Used - Fetus Not Named
.... 23.156 Observation - Autopsy Performed - Fetus Not Named
.... 23.157 Observation - Birth Weight - Fetus Not Named
.... 23.158 Observation - Birth Weight - Fetus Not Named, with Edit Flag
.... 23.159 Observation - Cigarette Smoking Before During Pregnancy - 3 months prior: Carmen Teresa Lee
.... 23.160 Observation - Cigarette Smoking Before During Pregnancy - first 3 months: Carmen Teresa Lee
.... 23.161 Observation - Cigarette Smoking Before During Pregnancy example - second 3 months: Carmen Teresa Lee
.... 23.162 Observation - Cigarette Smoking Before During Pregnancy - last 3 months: Carmen Teresa Lee
.... 23.163 Observation - Coded Initiating Cause of Fetal Death
.... 23.164 Observation - Coded Other Cause of Fetal Death
.... 23.165 Observation - Date of First Prenatal Care Visit - Carmen Teresa Lee
.... 23.166 Observation - Date of Last Live Birth - Carmen Teresa Lee
.... 23.167 Observation - Observation Estimated Fetal Death Time Point - Fetus Not Named
.... 23.168 Observation - Fetal Presentation - Fetus Not Named
.... 23.169 Observation - Gestational Age at Delivery - Fetus Not Named
.... 23.170 Observation - Gestational Age at Delivery - Fetus Not Named, with Edit Flag
.... 23.171 Observation - Histological Placental Exam Performed - Fetus Not Named
.... 23.172 Observation - InputRaceAndEthnicity example [carmen teresa lee]
.... 23.173 Observation - Last Menstrual Period - Carmen Teresa Lee
.... 23.174 Observation - Method of Disposition - Fetus Not Named
.... 23.175 Observation - Mother Height - Carmen Teresa Lee
.... 23.176 Observation - Mother Height - Carmen Teresa Lee, with Edit Flag
.... 23.177 Observation - Mother Prepregnancy Weight - Carmen Teresa Lee
.... 23.178 Observation - Mother Prepregnancy Weight - Carmen Teresa Lee, with Edit Flag
.... 23.179 Observation - Mother Received WIC Food - Carmen Teresa Lee
.... 23.180 Observation - Number of Births Now Dead - Carmen Teresa Lee
.... 23.181 Observation - Number of Fetal Deaths This Delivery - Carmen Teresa Lee
.... 23.182 Observation - Number Live Births This Delivery - Carmen Teresa Lee
.... 23.183 Observation - Number of Births Now Living - Carmen Teresa Lee
.... 23.184 Observations - Number Previous Cesareans - Carmen Teresa Lee
.... 23.185 Observations - Number Previous Cesareans - Carmen Teresa Lee, with Edit Flag
.... 23.186 Observation - Parent Education Level - Carmen Teresa Lee
.... 23.187 Observation - Parent Education Level - Carmen Teresa Lee, with Edit Flag
.... 23.188 Observation - Mother Present Job - Carmen Teresa Lee
.... 23.189 Observation - Father Present Job - Tom Yan Lee
.... 23.190 Procedure - Final Route / Method of Delivery - Fetus Not Named
.... 23.191 Patient - Decedent Fetus example [Fetus Not Named]
.... 23.192 Patient - Decedent Fetus example [Fetus Not Named], with Edit Flag
.... 23.193 Patient - Mother example [Carmen Teresa Lee]
.... 23.194 Patient - Mother example [Carmen Teresa Lee], with Edit Flag
.... 23.195 QuestionnaireResponse - Patient's Fetal Death Worksheet: Carmen Lee
.... 23.196 RelatedPerson - Father Natural - Vital Records - Tom Yan Lee
.... 23.197 RelatedPerson - Father Natural - Vital Records - Tom Yan Lee, with Edit Flag
.... 23.198 RelatedPerson - Mother Gestational - Vital Records - Carmen Teresa Lee
.... 23.199 Bundle - Coded Race and Ethnicity - Baby G Quinn
.... 23.200 Bundle - Jurisdiction Live Birth Report - Baby G Quinn
.... 23.201 Bundle - Provider Live Birth - Baby G Quinn
.... 23.202 Composition - Coded Race and Ethnicity - Baby G Quinn
.... 23.203 Composition - Jurisdiction Live Birth Report - BabyG Quinn
.... 23.204 Composition - Provider Live Birth Report - BabyG Quinn
.... 23.205 Condition - Chorioamnionitis - Jada Ann Quinn
.... 23.206 Condition - Congenital Anomaly of Newborn - BabyG Quinn
.... 23.207 Condition - Congenital Anomaly of Newborn - Baby G Quinn
.... 23.208 Condition - Eclampsia Hypertension - Jada Ann Quinn
.... 23.209 Condition - Gestational Diabetes - Jada Ann Quinn
.... 23.210 Condition - Gestational Hypertension - Jada Ann Quinn
.... 23.211 Condition - Infection Present During Pregnancy - Jada Ann Quinn
.... 23.212 Condition - Perineal Laceration - Jada Ann Quinn
.... 23.213 Condition - Prepregnancy Diabetes - Jada Ann Quinn
.... 23.214 Condition - Prepregnancy Hypertension - Carmen Teresa Lee
.... 23.215 Condition - Prepregnancy Hypertension - Jada Ann Quinn
.... 23.216 Condition - Ruptured Uterus - Jada Ann Quinn
.... 23.217 Condition - Seizure - BabyG Quinn
.... 23.218 Coverage - Principal Payer for Delivery - Jada Ann Quinn
.... 23.219 Encounter - Birth - Baby G Quinn
.... 23.220 Encounter - Maternity - Jada Ann Quinn
.... 23.221 Observation - Antibiotics Administered During Labor - Jada Ann Quinn
.... 23.222 Observation - Apgar Score - BabyG Quinn: 5 min
.... 23.223 Observation - Apgar Score - BabyG Quinn: 10 min
.... 23.224 Observation - Birth Weight - Baby G Quinn
.... 23.225 Observation - Birth Weight - Baby G Quinn, with Edit Flag
.... 23.226 Observation - Cigarette Smoking Before/During Pregnancy - Jada Ann Quinn: 3 months prior
.... 23.227 Observation - Cigarette Smoking Before/During Pregnancy - Jada Ann Quinn: first 3 months
.... 23.228 Observation - Cigarette Smoking Before/During Pregnancy - Jada Ann Quinn: second 3 months
.... 23.229 Observation - Cigarette Smoking Before/During Pregnancy - Jada Ann Quinn: last 3 months
.... 23.230 Observation - Date of First Prenatal Care Visit - Jada Ann Quinn
.... 23.231 Observation - Date of Last Live Birth - Jada Ann Quinn
.... 23.232 Observation - Date of Last Other Pregnancy Outcome - Jada Ann Quinn
.... 23.233 Observation - Fetal Presentation Baby G Quinn
.... 23.234 Observation - InputRaceAndEthnicity example [jada ann quinn]
.... 23.235 Observation - InputRaceAndEthnicity example [james-quinn]
.... 23.236 Observation - InputRaceAndEthnicity example [james-quinn with edit]
.... 23.237 Observation - Last Menstrual Period - Jada Ann Quinn
.... 23.238 Observation - Mother Delivery Weight - Jada Ann Quinn
.... 23.239 Observation - Mother Delivery Weight - Jada Ann Quinn, with Edit Flag
.... 23.240 Observation - Mother Height - Jada Ann Quinn
.... 23.241 Observation - Mother Height - Jada Ann Quinn, with Edit Flag
.... 23.242 Observation - None Of Specified Infections During Pregnancy - Jada Ann Quinn
.... 23.243 Observation - None Of Specified Obstetric Procedures - Jada Ann Quinn
.... 23.244 Observation - Paternity Acknowledgement Signed - James Quinn
.... 23.245 Observation - Paternity Acknowledgement Signed - James Quinn with edit reference
.... 23.246 Procedure - Final Route and Method of Delivery - Baby G Quinn
.... 23.247 Observation - Gestational Age at Delivery - Baby G Quinn
.... 23.248 Observation - Gestational Age at Delivery - Baby G Quinn, with Edit Flag
.... 23.249 Observation - ICU Admission - Jada Ann Quinn
.... 23.250 Observation - Infant Breastfed at Discharge - Baby G Quinn
.... 23.251 Observation - Infant Living - Baby G Quinn
.... 23.252 Observation - Labor Trial Attempted - Baby G Quinn
.... 23.253 Observation - Mother Married During Pregnancy - Jada Ann Quinn
.... 23.254 Observation - Mother Prepregnancy Weight - Jada Ann Quinn
.... 23.255 Observation - Mother Prepregnancy Weight - Jada Ann Quinn, with Edit Flag
.... 23.256 Observation - Mother Received WIC Food - Jada Ann Quinn
.... 23.257 Observation - NICU Admission - BabyG Quinn
.... 23.258 Observation - None Of Specified Abnormal Conditions of Newborn - BabyG Quinn
.... 23.259 Observation - None Of Specified Characteristics of Labor and Delivery - Jada Ann Quinn
.... 23.260 Observation - None Of Specified Maternal Morbidities - Jada Ann Quinn
.... 23.261 Observation - None of Specified Risk Factors - Jada Ann Quinn
.... 23.262 Observation - Number Births Now Dead - Jada Ann Quinn
.... 23.263 Observation - Number Births Now Living - Jada Ann Quinn
.... 23.264 Observation - Number Live Births This Delivery - Jada Ann Quinn
.... 23.265 Observation - Number Other Pregnancy Outcomes - Jada Ann Quinn
.... 23.266 Observation - Number Prenatal Visits - Jada Ann Quinn
.... 23.267 Observation - Number Prenatal Visits - Jada Ann Quinn, with Edit Flag
.... 23.268 Observation - Number Previous Cesareans - Jada Ann Quinn
.... 23.269 Observation - Number Previous Cesareans - Jada Ann Quinn, with Edit Flag
.... 23.270 Observation - Parent Education Level - Jada Ann Quinn
.... 23.271 Observation - Parent Education Level - Jada Ann Quinn, with Edit Flag
.... 23.272 Observation - Parent Education Level - James Quinn
.... 23.273 Observation - Parent Education Level - James Quinn, with Edit Flag
.... 23.274 Observation - Parent Education Level - Tom Yan Lee
.... 23.275 Observation - Parent Education Level - Tom Yan Lee, with Edit Flag
.... 23.276 Observation - Planned to Deliver at Home - Baby G Quinn
.... 23.277 Observation - Planned to Delivery at Home - Fetus Not Named
.... 23.278 Observation - Previous Cesarean - Jada Ann Quinn
.... 23.279 Observation - Previous Preterm Births - Jada Ann Quinn
.... 23.280 Observation - SSN Requested for Child - BabyG Quinn
.... 23.281 Observation - Administration of Steroids for Fetal Lung Maturation - Jada Ann Quinn
.... 23.282 Observation - Unknown Final Route Method of Delivery - Jada Ann Quinn
.... 23.283 Patient - Child example [Baby G Quinn]
.... 23.284 Patient - Child example [Baby G Quinn], with Edit Flag
.... 23.285 Patient - Mother Date Part Absent
.... 23.286 Patient - Mother Jada Ann Quinn
.... 23.287 Patient - Mother Jada Ann Quinn, with Edit Flag
.... 23.288 Procedure - Antibiotic for Suspected Neonatal Sepsis - BabyG Quinn
.... 23.289 Procedure - Artificial Insemniation - Jada Ann Quinn
.... 23.290 Procedure - Assisted Reproductive Technology - Jada Ann Quinn
.... 23.291 Procedure - Augmentation of Labor - Jada Ann Quinn
.... 23.292 Procedure - Blood Transfusion - Jada Ann Quinn
.... 23.293 Procedure - Epidural or Spinal Anesthesia - Jada Ann Quinn
.... 23.294 Procedure - Induction of Labor - Jada Ann Quinn
.... 23.295 Procedure - Infertility Treatment - Jada Ann Quinn
.... 23.296 Procedure - Obstetric Procedure - Jada Ann Quinn
.... 23.297 Procedure - Surfactant Replacement - BabyG Quinn
.... 23.298 Procedure Unplanned Hysterectomy - Jada Ann Quinn
.... 23.299 Procedure - Assisted Ventilation Following Delivery - BabyG Quinn
.... 23.300 Procedure - Assisted Ventilation More Than Six Hours - BabyG Quinn
.... 23.301 QuestionnaireResponse - Mother's Worksheet for Child's Birth Certificate: Jada Ann Quinn
.... 23.302 RelatedPerson - Father Natural - Vital Records - James Brandon Quinn
.... 23.303 RelatedPerson - Father Natural - Vital Records - James Brandon Quinn, with Edit Flag
.... 23.304 RelatedPerson - Mother Gestational - Vital Records - Jada Ann Quinn
.... 23.305 Observation - Father Present Job - James Brandon Quinn - coded
.... 23.306 Observation - Father Present Job - James Brandon Quinn
.... 23.307 Observation - Mother Present Job - Jada Ann Quinn - coded
.... 23.308 Observation - Mother Present Job - Jada Ann Quinn
.... 23.309 Bundle - Coded Industry and Occupation - Baby G Quinn
.... 23.310 Composition - Coded Industry and Occuption - Baby G Quinn
.... 23.311 Location BFDR - East Hospital
.... 23.312 Location BFDR - North Hospital
.... 23.313 Location BFDR - South Hospital
.... 23.314 Observation - Gestational Age at Delivery - Baby G Quinn - Premature
.... 23.315 Observation - Gestational Age at Delivery - Baby G Quinn - Premature in weeks
.... 23.316 Observation - Plurality of Pregnancy example [Carmen Teresa Lee]
.... 23.317 Observation - CodedRaceAndEthnicity example [Father]
.... 23.318 Observation - CodedRaceAndEthnicity example [Mother]
.... 23.319 Observation - InputRaceAndEthnicity example [Father]
.... 23.320 Observation - InputRaceAndEthnicity example [Mother]
.... 23.321 Observation - None Of Specified Congenital Anomolies of Newborn - BabyG Quinn
.... 23.322 US Core Organization - Jurisdictional Vital Records Office
.... 23.323 US Core Organization - National Center for Health Statistics [NCHS]
.... 23.324 US Core Organization - South Hospital
.... 23.325 Practitioner - Vital Records - Avery Jones, MD
.... 23.326 Practitioner - Vital Records - Janet Seito
.... 23.327 Practitioner - Vital Records - Jessica Leung