Additional Resources Included in Document

Entry 2 - fullUrl = http://www.example.org/fhir/Patient/Ex-Patient-1-for-secondaryUse-pandemnicIPS-stage-1

Resource Patient:

Profiles: Patient (IPS), Decedent

Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

---

Marital Status:	Never Married
Contact Detail	5590 Lockwood Drive Danville VA US
Unknown:	Joe Smith
NVSS SexAtDeath	Female
Spouse Is Alive	Yes
Patient Birth Place	Roanoke VA US

Entry 3 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentFather-Example1

Resource RelatedPerson:

Profile: Decedent Father

active: true

patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

relationship: father

name: Decedent Dad(Official)

Entry 4 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentMother-Example1

Resource RelatedPerson:

Profile: Decedent Mother

active: true

patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

relationship: mother

name: Decedent Mom(Name changed for Marriage)

Entry 5 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentSpouse-Example1

Resource RelatedPerson:

Profile: Decedent Spouse

active: true

patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

relationship: spouse

name: Decedent Spouse(Name changed for Marriage)

Entry 6 - fullUrl = http://www.example.org/fhir/Observation/DecedentAge-Example1

Resource Observation:

Profile: Decedent Age

status: Final

code: Age at death

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

value: 29 years (Details: UCUM codea = 'a')

Entry 7 - fullUrl = http://www.example.org/fhir/Observation/DecedentUsualWork-Example1

Resource Observation:

Profile: Decedent Usual Work

status: Final

code: History of Usual occupation

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

value: Health Care Assistants

Components

-	Code	Value[x]
*	History of Occupation Industry	Residential nursing care facilities

Entry 8 - fullUrl = http://www.example.org/fhir/Observation/DecedentPregnancyStatus-Example1

Resource Observation:

Profile: Decedent Pregnancy

status: Final

code: Timing of recent pregnancy in relation to death

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

value: Pregnant at time of death

Entry 9 - fullUrl = http://www.example.org/fhir/Observation/DeathDate-Example2

Resource Observation:

Profile: Death Date

status: Final

code: Date and time of death [TimeStamp]

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

effective: 2024-06-30 16:39:40-0500

performer: Practitioner Jane Purple (official)

value: Partial Date Time Vital Records:

component

code: Date and time pronounced dead [US Standard Certificate of Death]

value: 2024-06-30 16:39:40-0500

component

code: Location of death

value: Death in home

Entry 10 - fullUrl = http://www.example.org/fhir/Practitioner/Pronouncer-Example1

Resource Practitioner:

Profile: US Core Practitioner Profile

identifier: NPI/9941339101

name: Jane Purple (Official)

address: 44 South Street Rockville MD 20854 US

Entry 11 - fullUrl = http://www.example.org/fhir/Observation/MannerOfDeath-Example1

Resource Observation:

Profile: Manner of Death

status: Final

code: Manner of death

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

performer: Practitioner Jim Black (official)

value: Natural death

Entry 12 - fullUrl = http://www.example.org/fhir/Practitioner/Certifier-Example1

Resource Practitioner:

Profile: Death Certifier

Practitioner Role: Certifier

identifier: NPI/9941339100

name: Jim Black (Official)

address: 44 South Street Bird in Hand PA 17505 US

Entry 13 - fullUrl = http://www.example.org/fhir/Procedure/DeathCertification-Example1

Resource Procedure:

Profile: Death Certification Procedure

identifier: 180

status: Completed

code: Death certification

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

Performers

-	Function	Actor
*	Nurse Practitioner	Practitioner Jim Black (official)

Entry 14 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example1

Resource Observation:

Profile: Cause Of Death Part 1

status: Final

code: Cause of death [US Standard Certificate of Death]

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

performer: Practitioner Jim Black (official)

value: Covid-19

component

code: line number

value: 1

component

code: Disease onset to death interval

value: 4 hours

Entry 15 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example2

Resource Observation:

Profile: Cause Of Death Part 1

status: Final

code: Cause of death [US Standard Certificate of Death]

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

performer: Practitioner Jim Black (official)

value: Eclampsia

component

code: line number

value: 2

component

code: Disease onset to death interval

value: 3 months

Entry 16 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart2-Example1

Resource Observation:

Profile: Cause of Death Part 2

status: Final

code: Other significant causes or conditions of death

subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

performer: Practitioner Jim Black (official)

value: hypertensive heart disease

Entry 17 - fullUrl = http://www.example.org/fhir/Location/DispositionLocation-Example1

Resource Location:

Profile: Disposition Location

name: Rosewood Cemetary

type: Disposition Location

address: 303 Rosewood Ave Danville VA 24541 US

Entry 18 - fullUrl = http://www.example.org/fhir/Observation/RecordAxisCauseOfDeath-Example1

Resource Observation:

Profile: Record Axis Cause Of Death

status: Final

code: Cause of death record axis code [Automated]

subject: NCHS generated

value: COVID-19

Components

-	Code	Value[x]
*	position	1

Entry 19 - fullUrl = http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example1

Resource Observation:

Profile: Entity Axis Cause Of Death

status: Final

code: Cause of death entity axis code [Automated]

subject: NCHS generated

value: COVID-19

component

code: line number

value: 1

component

code: position

value: 1