<attester> <mode value="personal"/> </attester> <custodian> <reference value="Organization/Example-Smith-Johnson-OrganizationCustodian1"/> </custodian> <section> <title value="MHAD Source Form for Betsy Smith-Johnson"/> <code> <coding> <system value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs"/> <code value="advance_directive_source_form"/> </coding> </code> <text> <status value="additional"/> </text> <entry> <reference value="Binary/MHAD-Example-Smith-Johnson-Binary"/> </entry> </section> <section> <title value="Appointment of a Primary Healthcare Agent and Alternate Healthcare Agents"/> <code> <coding> <system value="http://loinc.org"/> <code value="81335-2"/> <display value="Healthcare Agent"/> </coding> </code> <text> <status value="additional"/> </text> <entry> <reference value="RelatedPerson/Example-Smith-Johnson-Notary2"/> </entry> <entry> <reference value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent3"/> </entry> <entry> <reference value="Consent/Example-Smith-Johnson-HealthcareAgentConsent2"/> </entry> </section> </Composition>


  
    
      
      
      
    
  
  
    
      
      
      
    
  
  
    
  
  
  
    
    
  
  
  <attester>
    <mode value="personal"/>
  </attester>
  <custodian>
    <reference value="Organization/Example-Smith-Johnson-OrganizationCustodian1"/>
  </custodian>
  <section>
    <title value="MHAD Source Form for Betsy Smith-Johnson"/>
    <code>
      <coding>
        <system value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs"/>
        <code value="advance_directive_source_form"/>
      </coding>
    </code>
    <text>
      <status value="additional"/>
    </text>
    <entry>
      <reference value="Binary/MHAD-Example-Smith-Johnson-Binary"/>
    </entry>
  </section>
  <section>
    <title value="Appointment of a Primary Healthcare Agent and Alternate Healthcare Agents"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="81335-2"/>
        <display value="Healthcare Agent"/>
      </coding>
    </code>
    <text>
      <status value="additional"/>
    </text>
    <entry>
      <reference value="RelatedPerson/Example-Smith-Johnson-Notary2"/>
    </entry>
    <entry>
      <reference value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent3"/>
    </entry>
    <entry>
      <reference value="Consent/Example-Smith-Johnson-HealthcareAgentConsent2"/>
    </entry>
  </section>
</Composition>