Structured Data Capture
4.0.0-ci-build - STU 4 CI-build International flag

Structured Data Capture, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/sdc/ and changes regularly. See the Directory of published versions

: Questionnaire - ANC Quick Check

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Questionnaire/anc-quick-check> a fhir:Questionnaire ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "anc-quick-check"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-render>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire anc-quick-check</b></p><a name=\"anc-quick-check\"> </a><a name=\"hcanc-quick-check\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-sdc-questionnaire-render.html\">Advanced Rendering Questionnaire</a></p></div><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> ANC_Quick_Check</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">A sample questionnaire using itemMedia and itemAnswerMedia extensions</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check#4.0.0-ci-build</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.reason-for-visit\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> reason-for-visit</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Why did you come?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.reason-for-visit\">5 options</a></td></tr>#xD;\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.reason-for-visit\"> </a><p><b>Answer options for reason-for-visit </b></p><ul><li style=\"font-size: 11px\">For a scheduled (routine) visit</li><li style=\"font-size: 11px\">For specific complaints about you or your baby</li><li style=\"font-size: 11px\">First visit</li><li style=\"font-size: 11px\">Follow-up visit</li><li style=\"font-size: 11px\">Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?</li></ul></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm" ] ;
     fhir:Extension.valueCoding [
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/version-algorithm" ] ;
       fhir:Coding.code [ fhir:value "semver" ]
     ]
  ] ;
  fhir:Questionnaire.url [ fhir:value "http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check"] ;
  fhir:Questionnaire.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.40.17.35.2" ]
  ] ;
  fhir:Questionnaire.version [ fhir:value "4.0.0-ci-build"] ;
  fhir:Questionnaire.name [ fhir:value "ANC_Quick_Check"] ;
  fhir:Questionnaire.title [ fhir:value "Questionnaire - ANC Quick Check"] ;
  fhir:Questionnaire.status [ fhir:value "active"] ;
  fhir:Questionnaire.experimental [ fhir:value "true"^^xsd:boolean] ;
  fhir:Questionnaire.subjectType [
     fhir:value "Patient" ;
     fhir:index -1
  ] ;
  fhir:Questionnaire.date [ fhir:value "2026-07-15T05:01:03+00:00"^^xsd:dateTime] ;
  fhir:Questionnaire.publisher [ fhir:value "HL7 International / FHIR Infrastructure"] ;
  fhir:Questionnaire.contact [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "HL7 International / FHIR Infrastructure" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fiwg" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fiwg" ]
     ]
  ] ;
  fhir:Questionnaire.description [ fhir:value "A sample questionnaire using itemMedia and itemAnswerMedia extensions"] ;
  fhir:Questionnaire.jurisdiction [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ;
       fhir:Coding.code [ fhir:value "001" ] ;
       fhir:Coding.display [ fhir:value "World" ]
     ]
  ] ;
  fhir:Questionnaire.item [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemMedia" ] ;
       fhir:Extension.valueAttachment [
         fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit.png" ]
       ]
     ] ;
     fhir:Questionnaire.item.linkId [ fhir:value "reason-for-visit" ] ;
     fhir:Questionnaire.item.text [ fhir:value "Why did you come?" ] ;
     fhir:Questionnaire.item.type [ fhir:value "choice" ] ;
     fhir:Questionnaire.item.answerOption [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia" ] ;
         fhir:Extension.valueAttachment [
           fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit-routine.png" ]
         ]
       ] ;
       fhir:Questionnaire.item.answerOption.valueString [ fhir:value "For a scheduled (routine) visit" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia" ] ;
         fhir:Extension.valueAttachment [
           fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit-specific-complaint.png" ]
         ]
       ] ;
       fhir:Questionnaire.item.answerOption.valueString [ fhir:value "For specific complaints about you or your baby" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia" ] ;
         fhir:Extension.valueAttachment [
           fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit-first.png" ]
         ]
       ] ;
       fhir:Questionnaire.item.answerOption.valueString [ fhir:value "First visit" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia" ] ;
         fhir:Extension.valueAttachment [
           fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit-follow-up.png" ]
         ]
       ] ;
       fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Follow-up visit" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia" ] ;
         fhir:Extension.valueAttachment [
           fhir:Attachment.url [ fhir:value "http://example.org/images/reason-for-visit-include-family-member.png" ]
         ]
       ] ;
       fhir:Questionnaire.item.answerOption.valueString [ fhir:value "Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?" ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Questionnaire/anc-quick-check.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Questionnaire/anc-quick-check.ttl> .