UV_Vital Records Birth and Fetal Death Reporting
1.1.0 - STU 1.1
UV_Vital Records Birth and Fetal Death Reporting
1.1.0 - STU 1.1
UV_Vital Records Birth and Fetal Death Reporting, published by IHE International. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/fhir-bfdr/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "bundle-provider-fetal-death-not-named",
"meta" : {
"versionId" : "4",
"lastUpdated" : "2023-08-29T06:22:00.568Z",
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Bundle-document-bfdr"
]
},
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:93bdc9cf-0d97-4b6f-9f11-876d8ea115eb"
},
"type" : "document",
"timestamp" : "2019-02-11T02:06:01.283Z",
"entry" : [
{
"fullUrl" : "http://example.org/fhir/Composition/composition-provider-fetal-death-not-named",
"resource" : {
"resourceType" : "Composition",
"id" : "composition-provider-fetal-death-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Composition-provider-fetal-death-report"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_composition-provider-fetal-death-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition composition-provider-fetal-death-not-named</b></p><a name=\"composition-provider-fetal-death-not-named\"> </a><a name=\"hccomposition-provider-fetal-death-not-named\"> </a><a name=\"hccomposition-provider-fetal-death-not-named-en-US\"> </a><p><b>identifier</b>: z03eab8c-11e8-4d0c-ad2a-b385395e27da</p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 69045-3}\">U.S. standard report of fetal death - 2003 revision</span></p><p><b>encounter</b>: <a href=\"Encounter-encounter-maternity-carmen-teresa-lee.html\">Encounter - Maternity (Carmen Teresa Lee)</a></p><p><b>date</b>: 2019-01-09</p><p><b>author</b>: <a href=\"Practitioner-practitioner-vital-records-jessica-leung.html\">Practitioner - Vital Records (Jessica Leung)</a></p><p><b>title</b>: Provider fetal death report Document</p></div>"
},
"extension" : [
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-fetal-death-report-number",
"valueIdentifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "FDR"
}
]
},
"value" : "9876"
}
},
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-fetal-death-local-file-number",
"valueIdentifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "FDRFN"
}
]
},
"value" : "11111-11111"
}
},
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-received-by-registrar",
"valueDateTime" : "2019-02-12"
}
],
"identifier" : {
"value" : "z03eab8c-11e8-4d0c-ad2a-b385395e27da"
},
"status" : "final",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "69045-3",
"display" : "U.S. standard report of fetal death - 2003 revision"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"encounter" : {
🔗 "reference" : "Encounter/encounter-maternity-carmen-teresa-lee",
"display" : "Encounter - Maternity (Carmen Teresa Lee)"
},
"date" : "2019-01-09",
"author" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-jessica-leung",
"display" : "Practitioner - Vital Records (Jessica Leung)"
}
],
"title" : "Provider fetal death report Document",
"section" : [
{
"title" : "Mother (prenatal) Section on the Fetal Death Report",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57073-9",
"display" : "Prenatal records"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-planned-to-deliver-at-home-not-named",
"display" : "Observation - Planned to Deliver at Home (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee",
"display" : "Observation - Date of First Prenatal Care Visit (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-last-menstrual-period-carmen-teresa-lee",
"display" : "Observation - Last Menstrual Period (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-number-births-now-living-carmen-teresa-lee",
"display" : "Observation - Number Births Now Living (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-number-births-now-dead-carmen-teresa-lee",
"display" : "Observation - Number Births Now Dead (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-date-of-last-live-birth-carmen-teresa-lee",
"display" : "Observation - Date of Last Live Birth (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-mother-height-carmen-teresa-lee",
"display" : "Observation - Mother Height (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee",
"display" : "Observation - Mother Prepregnancy Weight (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-mother-received-wic-food-carmen-teresa-lee",
"display" : "Observation - Mother Received WIC Food (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (3 months prior: Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (first 3 months: Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (last 3 months: Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (second 3 months: Carmen Teresa Lee)"
}
]
},
{
"title" : "Medical and Health Information on the Fetal Death Report",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "55752-0",
"display" : "Clinical information"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-number-previous-cesareans-carmen-teresa-lee",
"display" : "Observation - Number Previous Cesareans (Carmen Teresa Lee)"
},
{
🔗 "reference" : "Observation/observation-fetal-presentation-not-named",
"display" : "Observation - Fetal Presentation (Fetus Not Named)"
},
{
🔗 "reference" : "Procedure/procedure-final-route-method-delivery-not-named",
"display" : "Procedure - Final Route and Method of Delivery (Fetus Not Named)"
}
]
},
{
"title" : "Fetal delivery information section on the Fetal Death Report",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "76400-1",
"display" : "Fetal delivery information Document [US Standard Report of Fetal Death]"
}
]
},
"entry" : [
{
🔗 "reference" : "Observation/observation-birth-weight-not-named",
"display" : "Observation - Birth Weight (Fetus Not Named)"
},
{
🔗 "reference" : "Observation/observation-gestational-age-at-delivery-not-named",
"display" : "Observation - Gestational Age at Delivery (Fetus Not Named)"
},
{
🔗 "reference" : "Condition/condition-fetal-death-cause-or-condition-not-named",
"display" : "Condition - Fetal Death Cause or Condition (Fetus Not Named)"
},
{
🔗 "reference" : "Condition/condition-fetal-death-other-significant-cause-not-named",
"display" : "Example of Condition-fetal-death-other-significant-cause profile (Fetus Not Named)"
},
{
🔗 "reference" : "Observation/observation-fetal-death-time-point-not-named",
"display" : "Example of Observation-estimated-fetal-death-time-point profile (Fetus Not Named)"
},
{
🔗 "reference" : "Observation/observation-autopsy-performed-not-named",
"display" : "Example of Observation-autopsy-performed profile (Fetus Not Named)"
},
{
🔗 "reference" : "Observation/observation-histological-placental-exam-performed-not-named",
"display" : "Observation - Histological Placental Exam Performed (Fetus Not Named)"
},
{
🔗 "reference" : "Observation/observation-autopsy-histological-exam-results-used-not-named",
"display" : "Observation - Autopsy or Histological Exam Results Used"
}
]
},
{
"title" : "Mother Administrative Section on the Fetal Death Report",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "92014-0",
"display" : "Mother's administrative information"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-parent-education-level-carmen-teresa-lee",
"display" : "Observation - Parent Education Level (Carmen Teresa Lee)"
}
]
},
{
"title" : "Mother's QuestionnaireResponse Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "74465-6",
"display" : "Questionnaire response Document"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"entry" : [
{
🔗 "reference" : "QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee",
"display" : "QuestionnaireResponse - Patient's Worksheet for Fetal Death Report"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Patient/patient-decedent-fetus-not-named",
"resource" : {
"resourceType" : "Patient",
"id" : "patient-decedent-fetus-not-named",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-decedent-fetus-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient-decedent-fetus-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-decedent-fetus-not-named</b></p><a name=\"patient-decedent-fetus-not-named\"> </a><a name=\"hcpatient-decedent-fetus-not-named\"> </a><a name=\"hcpatient-decedent-fetus-not-named-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">UNK Female, DoB: 2019-01-09 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known status of Patient\">Deceased:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.\"><a href=\"http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-patient-birthPlace.html\">Patient Birth Place</a></td><td colspan=\"3\">Ann Arbor MI 48103 </td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The fetal death status of the patient.\"><a href=\"http://hl7.org/fhir/us/vr-common-library/STU1.1/StructureDefinition-Extension-patient-fetal-death-vr.html\">Extension - Patient Fetal Death - Vital Records</a></td><td colspan=\"3\"><a href=\"http://snomed.info/id/276507005\">SNOMED CT (all versions)</a> 276507005: Fetal death (event)</td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode" : "F"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
"valueAddress" : {
"city" : "Ann Arbor",
"state" : "MI",
"postalCode" : "48103"
}
},
{
"url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-patient-fetal-death-vr",
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "276507005",
"display" : "Fetal death (event)"
}
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hospital.smarthealthit.org",
"value" : "9932702"
}
],
"name" : [
{
"family" : "UNK",
"_family" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode" : "not-applicable"
}
]
}
}
],
"gender" : "female",
"birthDate" : "2019-01-09",
"_birthDate" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/patient-birthTime",
"valueDateTime" : "2019-01-09T18:23:00-07:00"
}
]
},
"deceasedBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/Encounter/encounter-maternity-carmen-teresa-lee",
"resource" : {
"resourceType" : "Encounter",
"id" : "encounter-maternity-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Encounter-maternity"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_encounter-maternity-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter-maternity-carmen-teresa-lee</b></p><a name=\"encounter-maternity-carmen-teresa-lee\"> </a><a name=\"hcencounter-maternity-carmen-teresa-lee\"> </a><a name=\"hcencounter-maternity-carmen-teresa-lee-en-US\"> </a><p><b>identifier</b>: <code>http://hospital.smarthealthit.org</code>/8937015</p><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-IMP\">ActCode</a> IMP: inpatient encounter</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99234}\">Under Observation or Inpatient Care Services (Including Admission and Discharge Services)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Individual</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://loinc.org 87286-1}\">Birth attendant [Extended Identifier]</span></td><td><a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner - Vital Records (Janet Seito, MD)</a></td></tr></table><p><b>period</b>: 2019-01-08 10:00:00-0700 --> 2019-01-09 17:00:00-0700</p><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td><td><b>PhysicalType</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Location-location-south-hospital.html\">Location - US Core Location (South Hospital)</a></td><td><span title=\"Codes:{http://snomed.info/sct 22232009}\">Hospital</span></td></tr></table><p><b>serviceProvider</b>: <a href=\"Organization-organization-south-hospital.html\">Organization - US Core Organization (South Hospital Organization)</a></p></div>"
},
"identifier" : [
{
"system" : "http://hospital.smarthealthit.org",
"value" : "8937015"
}
],
"status" : "finished",
"class" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "IMP",
"display" : "inpatient encounter"
},
"type" : [
{
"coding" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "99234"
}
],
"text" : "Under Observation or Inpatient Care Services (Including Admission and Discharge Services)"
}
],
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"participant" : [
{
"type" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87286-1",
"display" : "Birth attendant [Extended Identifier]"
}
]
}
],
"individual" : {
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito",
"display" : "Practitioner - Vital Records (Janet Seito, MD)"
}
}
],
"period" : {
"start" : "2019-01-08T10:00:00-07:00",
"end" : "2019-01-09T17:00:00-07:00"
},
"location" : [
{
"location" : {
🔗 "reference" : "Location/location-south-hospital",
"display" : "Location - US Core Location (South Hospital)"
},
"physicalType" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "22232009",
"display" : "Hospital"
}
]
}
}
],
"serviceProvider" : {
🔗 "reference" : "Organization/organization-south-hospital",
"display" : "Organization - US Core Organization (South Hospital Organization)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Practitioner/practitioner-vital-records-jessica-leung",
"resource" : {
"resourceType" : "Practitioner",
"id" : "practitioner-vital-records-jessica-leung",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Practitioner-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner-vital-records-jessica-leung\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner-vital-records-jessica-leung</b></p><a name=\"practitioner-vital-records-jessica-leung\"> </a><a name=\"hcpractitioner-vital-records-jessica-leung\"> </a><a name=\"hcpractitioner-vital-records-jessica-leung-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">NPI</a>/223347055</p><p><b>name</b>: Leung Jessica </p><h3>Qualifications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor OTH}\">Birth Clerk</span></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "223347055"
}
],
"name" : [
{
"family" : "Jessica",
"given" : [
"Leung"
]
}
],
"qualification" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
"code" : "OTH",
"display" : "other"
}
],
"text" : "Birth Clerk"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Patient/patient-mother-carmen-teresa-lee",
"resource" : {
"resourceType" : "Patient",
"id" : "patient-mother-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient-mother-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-mother-carmen-teresa-lee</b></p><a name=\"patient-mother-carmen-teresa-lee\"> </a><a name=\"hcpatient-mother-carmen-teresa-lee\"> </a><a name=\"hcpatient-mother-carmen-teresa-lee-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Alternate names (see the one above)\">Alt. Name:</td><td colspan=\"3\">Carmen Teresa Santos (Name changed for Marriage)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">3670 Miller Road Ann Arbor MI 48103 US (home)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Patient Links\">Links:</td><td colspan=\"3\"><ul><li>Also see: <a href=\"RelatedPerson-relatedperson-mother-carmen-teresa-lee.html\">RelatedPerson Carmen Teresa Lee (official)</a></li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.\">US Core Ethnicity Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2135-2\">Race & Ethnicity - CDC</a> 2135-2: Hispanic or Latino</li><li>text: Hispanic or Latino</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The registered place of birth of the patient. A sytem may use the address.text if they don't store the birthPlace address in discrete elements.\"><a href=\"http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-patient-birthPlace.html\">Patient Birth Place</a></td><td colspan=\"3\">PR </td></tr><tr><td style=\"background-color: #f3f5da\" title=\"A code classifying the person's sex assigned at birth as specified by the [Office of the National Coordinator for Health IT (ONC)](https://www.healthit.gov/newsroom/about-onc). This extension aligns with the C-CDA Birth Sex Observation (LOINC 76689-9).\"><a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-birthsex.html\">US Core Birth Sex Extension</a></td><td colspan=\"3\">F</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2054-5\">Race & Ethnicity - CDC</a> 2054-5: Black or African American</li><li>text: Black or African America</li></ul></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2054-5",
"display" : "Black or African American"
}
},
{
"url" : "text",
"valueString" : "Black or African America"
}
]
},
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2135-2",
"display" : "Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Hispanic or Latino"
}
]
},
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode" : "F"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
"valueAddress" : {
"state" : "PR"
}
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hospital.smarthealthit.org",
"value" : "9992702"
}
],
"name" : [
{
"use" : "official",
"family" : "Lee",
"given" : [
"Carmen",
"Teresa"
]
},
{
"use" : "maiden",
"family" : "Santos",
"given" : [
"Carmen",
"Teresa"
]
}
],
"gender" : "female",
"birthDate" : "1986-02-15",
"address" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator-vr",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "N",
"display" : "No"
}
}
],
"use" : "home",
"line" : [
"3670 Miller Road"
],
"city" : "Ann Arbor",
"state" : "MI",
"postalCode" : "48103",
"country" : "US"
}
],
"link" : [
{
"other" : {
🔗 "reference" : "RelatedPerson/relatedperson-mother-carmen-teresa-lee"
},
"type" : "seealso"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-planned-to-deliver-at-home-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-planned-to-deliver-at-home-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-planned-to-deliver-at-home"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-planned-to-deliver-at-home-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-planned-to-deliver-at-home-not-named</b></p><a name=\"observation-planned-to-deliver-at-home-not-named\"> </a><a name=\"hcobservation-planned-to-deliver-at-home-not-named\"> </a><a name=\"hcobservation-planned-to-deliver-at-home-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73765-0}\">Planned to deliver at home?</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: false</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73765-0",
"display" : "Mother Planned to deliver at home [US Standard Certificate of Live Birth]"
}
],
"text" : "Planned to deliver at home?"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueBoolean" : false
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-date-of-first-prenatal-care-visit-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-first-prenatal-care-visit"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-date-of-first-prenatal-care-visit-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-date-of-first-prenatal-care-visit-carmen-teresa-lee</b></p><a name=\"observation-date-of-first-prenatal-care-visit-carmen-teresa-lee\"> </a><a name=\"hcobservation-date-of-first-prenatal-care-visit-carmen-teresa-lee\"> </a><a name=\"hcobservation-date-of-first-prenatal-care-visit-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69044-6}\">Date of first prenatal care visit</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 2018-05-18</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "69044-6",
"display" : "Date first prenatal visit"
}
],
"text" : "Date of first prenatal care visit"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2018-05-18"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-last-menstrual-period-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-last-menstrual-period-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-last-menstrual-period-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-last-menstrual-period-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-last-menstrual-period-carmen-teresa-lee</b></p><a name=\"observation-last-menstrual-period-carmen-teresa-lee\"> </a><a name=\"hcobservation-last-menstrual-period-carmen-teresa-lee\"> </a><a name=\"hcobservation-last-menstrual-period-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 8665-2}\">Last menstrual period start date</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 2018-04-18</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "8665-2",
"display" : "Last menstrual period start date"
}
],
"text" : "Last menstrual period start date"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2018-04-18"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-births-now-living-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-births-now-living-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-living-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-number-births-now-living-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-births-now-living-carmen-teresa-lee</b></p><a name=\"observation-number-births-now-living-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-births-now-living-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-births-now-living-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 11638-4}\">[#] Births.still living</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 1</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11638-4",
"display" : "[#] Births.still living"
}
],
"text" : "[#] Births.still living"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 1
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-births-now-dead-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-births-now-dead-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-dead-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-number-births-now-dead-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-births-now-dead-carmen-teresa-lee</b></p><a name=\"observation-number-births-now-dead-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-births-now-dead-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-births-now-dead-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 68496-9}\">Previous live births now dead #</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 0</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68496-9",
"display" : "Previous live births now dead #"
}
],
"text" : "Previous live births now dead #"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-date-of-last-live-birth-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-date-of-last-live-birth-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-last-live-birth"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-date-of-last-live-birth-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-date-of-last-live-birth-carmen-teresa-lee</b></p><a name=\"observation-date-of-last-live-birth-carmen-teresa-lee\"> </a><a name=\"hcobservation-date-of-last-live-birth-carmen-teresa-lee\"> </a><a name=\"hcobservation-date-of-last-live-birth-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 68499-3}\">Date of last live birth</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 2016-01-28</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68499-3",
"display" : "Date last live birth"
}
],
"text" : "Date of last live birth"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2016-01-28"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-height-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-height-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-height-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-mother-height-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-height-carmen-teresa-lee</b></p><a name=\"observation-mother-height-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-height-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-height-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category vital-signs}\">Vital Signs</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 3137-7}\">Body height Measured</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-01-10</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 65 [in_i]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code[in_i] = '[in_i]')</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "vital-signs",
"display" : "Vital Signs"
}
],
"text" : "Vital Signs"
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "3137-7",
"display" : "Body height Measured"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-01-10",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 65,
"system" : "http://unitsofmeasure.org",
"code" : "[in_i]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-prepregnancy-weight-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-prepregnancy-weight-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-mother-prepregnancy-weight-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-prepregnancy-weight-carmen-teresa-lee</b></p><a name=\"observation-mother-prepregnancy-weight-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-prepregnancy-weight-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-prepregnancy-weight-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category vital-signs}\">Vital Signs</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 56077-1}\">Body weight --pre current pregnancy</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-05-20</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 180 [lb_av]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code[lb_av] = '[lb_av]')</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "vital-signs",
"display" : "Vital Signs"
}
],
"text" : "Vital Signs"
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "56077-1",
"display" : "Body weight --pre current pregnancy"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-05-20",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 180,
"system" : "http://unitsofmeasure.org",
"code" : "[lb_av]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-received-wic-food-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-received-wic-food-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-mother-received-wic-food"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-mother-received-wic-food-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-received-wic-food-carmen-teresa-lee</b></p><a name=\"observation-mother-received-wic-food-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-received-wic-food-carmen-teresa-lee\"> </a><a name=\"hcobservation-mother-received-wic-food-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87303-4}\">Did mother get WIC food for herself during this pregnancy?</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 N}\">No</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87303-4",
"display" : "Mother WIC food recipient"
}
],
"text" : "Did mother get WIC food for herself during this pregnancy?"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "N",
"display" : "No"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-1-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-cig-smoking-pregnancy-1-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-1-carmen-teresa-lee</b></p><a name=\"observation-cig-smoking-pregnancy-1-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-1-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-1-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 64794-1}\">In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>focus</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 0</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "64794-1",
"display" : "In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]"
}
],
"text" : "In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-2-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-cig-smoking-pregnancy-2-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-2-carmen-teresa-lee</b></p><a name=\"observation-cig-smoking-pregnancy-2-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-2-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-2-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87298-6}\">Cigarettes smoked per day by Mother--1st trimester</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>focus</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 0</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87298-6",
"display" : "Cigarettes smoked per day by Mother--1st trimester"
}
],
"text" : "Cigarettes smoked per day by Mother--1st trimester"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-3-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-cig-smoking-pregnancy-3-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-3-carmen-teresa-lee</b></p><a name=\"observation-cig-smoking-pregnancy-3-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-3-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-3-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87299-4}\">Cigarettes smoked per day by Mother--2nd trimester</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>focus</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 1</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87299-4",
"display" : "Cigarettes smoked per day by Mother--2nd trimester"
}
],
"text" : "Cigarettes smoked per day by Mother--2nd trimester"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueInteger" : 1
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-4-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-cig-smoking-pregnancy-4-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-4-carmen-teresa-lee</b></p><a name=\"observation-cig-smoking-pregnancy-4-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-4-carmen-teresa-lee\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-4-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 64795-8}\">In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>focus</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 0</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "64795-8",
"display" : "In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]"
}
],
"text" : "In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-previous-cesareans-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-previous-cesareans-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-previous-cesareans-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-number-previous-cesareans-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-previous-cesareans-carmen-teresa-lee</b></p><a name=\"observation-number-previous-cesareans-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-previous-cesareans-carmen-teresa-lee\"> </a><a name=\"hcobservation-number-previous-cesareans-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 68497-7}\">Previous cesarean deliveries #</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 1</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68497-7",
"display" : "Previous cesarean deliveries #"
}
],
"text" : "Previous cesarean deliveries #"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 1
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-fetal-presentation-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-fetal-presentation-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-fetal-presentation"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-fetal-presentation-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-fetal-presentation-not-named</b></p><a name=\"observation-fetal-presentation-not-named\"> </a><a name=\"hcobservation-fetal-presentation-not-named\"> </a><a name=\"hcobservation-fetal-presentation-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73761-9}\">Fetal presentation--at birth [US Standard Certificate of Live Birth]</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 6096002}\">Breech presentation (finding)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73761-9",
"display" : "Fetal presentation--at birth [US Standard Certificate of Live Birth]"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "6096002",
"display" : "Breech presentation (finding)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/procedure-final-route-method-delivery-not-named",
"resource" : {
"resourceType" : "Procedure",
"id" : "procedure-final-route-method-delivery-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-final-route-method-delivery"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_procedure-final-route-method-delivery-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure procedure-final-route-method-delivery-not-named</b></p><a name=\"procedure-final-route-method-delivery-not-named\"> </a><a name=\"hcprocedure-final-route-method-delivery-not-named\"> </a><a name=\"hcprocedure-final-route-method-delivery-not-named-en-US\"> </a><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 48782003}\">Spontaneous vaginal delivery</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>performed</b>: 2019-01-19 18:00:00-0700 --> 2019-01-19 18:23:00-0700</p></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "48782003",
"display" : "Delivery normal (finding)"
}
],
"text" : "Spontaneous vaginal delivery"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"performedPeriod" : {
"start" : "2019-01-19T18:00:00-07:00",
"end" : "2019-01-19T18:23:00-07:00"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-birth-weight-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-birth-weight-not-named",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-birth-weight-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-birth-weight-not-named</b></p><a name=\"observation-birth-weight-not-named\"> </a><a name=\"hcobservation-birth-weight-not-named\"> </a><a name=\"hcobservation-birth-weight-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category vital-signs}\">Vital Signs</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 8339-4}\">Birth weight Measured</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-02-10</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 1530 g<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codeg = 'g')</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "vital-signs",
"display" : "Vital Signs"
}
],
"text" : "Vital Signs"
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "8339-4",
"display" : "Birth weight Measured"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-02-10",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 1530,
"system" : "http://unitsofmeasure.org",
"code" : "g"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-gestational-age-at-delivery-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-gestational-age-at-delivery-not-named",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-gestational-age-at-delivery-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-gestational-age-at-delivery-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-gestational-age-at-delivery-not-named</b></p><a name=\"observation-gestational-age-at-delivery-not-named\"> </a><a name=\"hcobservation-gestational-age-at-delivery-not-named\"> </a><a name=\"hcobservation-gestational-age-at-delivery-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 11884-4}\">Gestational age Estimated</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 20 wk<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codewk = 'wk')</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11884-4",
"display" : "Gestational age Estimated"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 20,
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-fetal-death-cause-or-condition-not-named",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-fetal-death-cause-or-condition-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-fetal-death-cause-or-condition"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-fetal-death-cause-or-condition-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-fetal-death-cause-or-condition-not-named</b></p><a name=\"condition-fetal-death-cause-or-condition-not-named\"> </a><a name=\"hccondition-fetal-death-cause-or-condition-not-named\"> </a><a name=\"hccondition-fetal-death-cause-or-condition-not-named-en-US\"> </a><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span>, <span title=\"Codes:{http://loinc.org 76060-3}\">Initiating cause or condition of fetal death [US Standard Report of Fetal Death]</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 44223004}\">Premature rupture of membranes (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p></div>"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "encounter-diagnosis",
"display" : "Encounter Diagnosis"
}
]
},
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "76060-3",
"display" : "Initiating cause or condition of fetal death [US Standard Report of Fetal Death]"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "44223004",
"display" : "Premature rupture of membranes (disorder)"
}
],
"text" : "Premature rupture of membranes (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-fetal-death-other-significant-cause-not-named",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-fetal-death-other-significant-cause-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-fetal-death-other-cause-or-condition"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-fetal-death-other-significant-cause-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-fetal-death-other-significant-cause-not-named</b></p><a name=\"condition-fetal-death-other-significant-cause-not-named\"> </a><a name=\"hccondition-fetal-death-other-significant-cause-not-named\"> </a><a name=\"hccondition-fetal-death-other-significant-cause-not-named-en-US\"> </a><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span>, <span title=\"Codes:{http://loinc.org 76061-1}\">Other significant causes or conditions of fetal death [US Standard Report of Fetal Death]</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 237292005}\">Placental insufficiency (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p></div>"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "encounter-diagnosis",
"display" : "Encounter Diagnosis"
}
]
},
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "76061-1",
"display" : "Other significant causes or conditions of fetal death [US Standard Report of Fetal Death]"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "237292005",
"display" : "Placental insufficiency (disorder)"
}
],
"text" : "Placental insufficiency (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-fetal-death-time-point-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-fetal-death-time-point-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-estimated-fetal-death-time-point"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-fetal-death-time-point-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-fetal-death-time-point-not-named</b></p><a name=\"observation-fetal-death-time-point-not-named\"> </a><a name=\"hcobservation-fetal-death-time-point-not-named\"> </a><a name=\"hcobservation-fetal-death-time-point-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73811-2}\">Estimated timing of fetal death [US Standard Report of Fetal Death]</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 434631000124100}\">Fetal intrapartum death after first assessment (event)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73811-2",
"display" : "Estimated timing of fetal death [US Standard Report of Fetal Death]"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "434631000124100",
"display" : "Fetal intrapartum death after first assessment (event)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-autopsy-performed-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-autopsy-performed-not-named",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-autopsy-performed-indicator-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-autopsy-performed-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-autopsy-performed-not-named</b></p><a name=\"observation-autopsy-performed-not-named\"> </a><a name=\"hcobservation-autopsy-performed-not-named\"> </a><a name=\"hcobservation-autopsy-performed-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 85699-7}\">Autopsy was performed</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 716347009}\">Autopsy performed (situation)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85699-7",
"display" : "Autopsy was performed"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "716347009",
"display" : "Autopsy performed (situation)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-histological-placental-exam-performed-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-histological-placental-exam-performed-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-histological-placental-exam-performed"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-histological-placental-exam-performed-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-histological-placental-exam-performed-not-named</b></p><a name=\"observation-histological-placental-exam-performed-not-named\"> </a><a name=\"hcobservation-histological-placental-exam-performed-not-named\"> </a><a name=\"hcobservation-histological-placental-exam-performed-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73767-6}\">Histological placental examination was performed [US Standard Report of Fetal Death]</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 398166005}\">Performed</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73767-6",
"display" : "Histological placental examination was performed [US Standard Report of Fetal Death]"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "398166005",
"display" : "Performed"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-autopsy-histological-exam-results-used-not-named",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-autopsy-histological-exam-results-used-not-named",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-autopsy-histological-exam-results-used"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-autopsy-histological-exam-results-used-not-named\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-autopsy-histological-exam-results-used-not-named</b></p><a name=\"observation-autopsy-histological-exam-results-used-not-named\"> </a><a name=\"hcobservation-autopsy-histological-exam-results-used-not-named\"> </a><a name=\"hcobservation-autopsy-histological-exam-results-used-not-named-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 74498-7}\">Autopsy or histological placental examination results were used [US Standard Report of Fetal Death]</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0136 Y}\">Yes</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "74498-7",
"display" : "Autopsy or histological placental examination results were used [US Standard Report of Fetal Death]"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0136",
"code" : "Y",
"display" : "Yes"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-parent-education-level-carmen-teresa-lee",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-parent-education-level-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-parent-education-level-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-parent-education-level-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-parent-education-level-carmen-teresa-lee</b></p><a name=\"observation-parent-education-level-carmen-teresa-lee\"> </a><a name=\"hcobservation-parent-education-level-carmen-teresa-lee\"> </a><a name=\"hcobservation-parent-education-level-carmen-teresa-lee-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 57712-2}\">Highest level of education Mother</span></p><p><b>subject</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Patient - Mother (Carmen Teresa Lee)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-carmen-teresa-lee.html\">Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{urn:oid:2.16.840.1.114222.4.5.274 PHC1449}\">9th through 12th grade; no diploma</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57712-2",
"display" : "Highest level of education Mother"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:oid:2.16.840.1.114222.4.5.274",
"code" : "PHC1449",
"display" : "9th through 12th grade; no diploma"
}
],
"text" : "9th through 12th grade; no diploma"
}
}
},
{
"fullUrl" : "http://example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "QuestionnaireResponse-patients-fetal-death-carmen-lee",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_QuestionnaireResponse-patients-fetal-death-carmen-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse QuestionnaireResponse-patients-fetal-death-carmen-lee</b></p><a name=\"QuestionnaireResponse-patients-fetal-death-carmen-lee\"> </a><a name=\"hcQuestionnaireResponse-patients-fetal-death-carmen-lee\"> </a><a name=\"hcQuestionnaireResponse-patients-fetal-death-carmen-lee-en-US\"> </a><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 : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"http://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\"/></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 : 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=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> QuestionnaireResponse-patients-fetal-death-carmen-lee</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire:<a href=\"Questionnaire-Questionnaire-patients-fetal-death.html\">Questionnaire - Patient's Worksheet for the Report of Fetal Death</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-current-legal-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is your current legal name?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-first-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Carmen</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-middle-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Middle</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Teresa</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-last-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Last</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Lee</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-address</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Where do you usually live - that is - where is your household/residence located?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-nbr-street</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Complete number and street (do not enter rural route numbers)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">3670 Miller Road</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-city</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">City, Town, or Location</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-state</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">State (or U.S. Territory, Canadian Province)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">MI</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-zip</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Zip Code</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">48103</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> inside-city-limits</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0532.html#v2-0532-N\">expandedYes-NoIndicator</a> N: No</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-mail</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is your mailing address</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-mail-same</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Same as residence [Go to next question]</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">true</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-dob</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is your date of birth?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1986-02-15</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-birthplace</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In what State, U.S. territory, or foreign country were you born? Please specify one of the following:</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-birthplace-territory</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">or U.S. territory, i.e., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa or Norther Marianas</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">PR</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-education</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>unknown PHC1449: 9th through 12th grade; no diploma</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-ethnicity</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box.</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-shl</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Are you Spanish/Hispanic/Latina</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2135-2\">Race & Ethnicity - CDC</a> 2135-2: Hispanic or Latino</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mother-race</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is your race? (Please check one or more races to indicate what you consider yourself to be).</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mother-race-category</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Race categories</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2054-5\">Race & Ethnicity - CDC</a> 2054-5: Black or African American</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> father-current-legal-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is the current legal name of your baby's father?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> father-first-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Tom</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> father-middle-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Middle</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Yan</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> father-last-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Last</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Lee</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> father-dob</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is the father's date of birth?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1984-02-27</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> father-birthplace</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">In what State, U.S. territory, or foreign country was the father born? Please specify one of the following:</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> father-birthplace-state</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">State</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">NY</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> receive-wic</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Did you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span><a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0532.html#v2-0532-N\">expandedYes-NoIndicator</a> N: No</span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-height</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What is your height?</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-height-inches</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Inches</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>65 [in_i]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code[in_i] = '[in_i]')</span></span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-prepregnancy-weight</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">lbs</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>180 [lb_av]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code[lb_av] = '[lb_av]')</span></span></span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" 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-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-3-months-prior</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Three months before pregnancy</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-3-months-prior-cig</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of cigarettes*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-3-months-prior-pck</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of packs</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First three months of pregnancy</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-1-cig</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of cigarettes*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-1-pck</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of packs</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-2</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Second three months of pregnancy</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0110.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-2-cig</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of cigarettes*</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.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-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-2-pck</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of packs</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck001.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-3</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Third trimester of pregnancy</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0010.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-3-cig</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of cigarettes*</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0000.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-3-pck</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"># of packs</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0</td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"http://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></div>"
},
"questionnaire" : "https://profiles.ihe.net/QRPH/bfdr/Questionnaire/Questionnaire-patients-fetal-death",
"status" : "completed",
"subject" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"source" : {
🔗 "reference" : "Patient/patient-mother-carmen-teresa-lee",
"display" : "Patient - Mother (Carmen Teresa Lee)"
},
"item" : [
{
"linkId" : "mother-current-legal-name",
"text" : "What is your current legal name?",
"item" : [
{
"linkId" : "mother-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Carmen"
}
]
},
{
"linkId" : "mother-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "Teresa"
}
]
},
{
"linkId" : "mother-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "Lee"
}
]
}
]
},
{
"linkId" : "mother-address",
"text" : "Where do you usually live - that is - where is your household/residence located?",
"item" : [
{
"linkId" : "mother-nbr-street",
"text" : "Complete number and street (do not enter rural route numbers)",
"answer" : [
{
"valueString" : "3670 Miller Road"
}
]
},
{
"linkId" : "mother-city",
"text" : "City, Town, or Location"
},
{
"linkId" : "mother-state",
"text" : "State (or U.S. Territory, Canadian Province)",
"answer" : [
{
"valueString" : "MI"
}
]
},
{
"linkId" : "mother-zip",
"text" : "Zip Code",
"answer" : [
{
"valueString" : "48103"
}
]
}
]
},
{
"linkId" : "inside-city-limits",
"text" : "Is this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?",
"answer" : [
{
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "N",
"display" : "No"
}
}
]
},
{
"linkId" : "mother-mail",
"text" : "What is your mailing address",
"item" : [
{
"linkId" : "mother-mail-same",
"text" : "Same as residence [Go to next question]",
"answer" : [
{
"valueBoolean" : true
}
]
}
]
},
{
"linkId" : "mother-dob",
"text" : "What is your date of birth?",
"answer" : [
{
"valueDate" : "1986-02-15"
}
]
},
{
"linkId" : "mother-birthplace",
"text" : "In what State, U.S. territory, or foreign country were you born? Please specify one of the following:",
"item" : [
{
"linkId" : "mother-birthplace-territory",
"text" : "or U.S. territory, i.e., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa or Norther Marianas",
"answer" : [
{
"valueString" : "PR"
}
]
}
]
},
{
"linkId" : "mother-education",
"text" : "What is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.114222.4.5.274",
"code" : "PHC1449",
"display" : "9th through 12th grade; no diploma"
}
}
]
},
{
"linkId" : "mother-ethnicity",
"text" : "Are you Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box.",
"item" : [
{
"linkId" : "mother-shl",
"text" : "Are you Spanish/Hispanic/Latina",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2135-2",
"display" : "Hispanic or Latino"
}
}
]
}
]
},
{
"linkId" : "mother-race",
"text" : "What is your race? (Please check one or more races to indicate what you consider yourself to be).",
"item" : [
{
"linkId" : "mother-race-category",
"text" : "Race categories",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2054-5",
"display" : "Black or African American"
}
}
]
}
]
},
{
"linkId" : "father-current-legal-name",
"text" : "What is the current legal name of your baby's father?",
"item" : [
{
"linkId" : "father-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Tom"
}
]
},
{
"linkId" : "father-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "Yan"
}
]
},
{
"linkId" : "father-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "Lee"
}
]
}
]
},
{
"linkId" : "father-dob",
"text" : "What is the father's date of birth?",
"answer" : [
{
"valueDate" : "1984-02-27"
}
]
},
{
"linkId" : "father-birthplace",
"text" : "In what State, U.S. territory, or foreign country was the father born? Please specify one of the following:",
"item" : [
{
"linkId" : "father-birthplace-state",
"text" : "State",
"answer" : [
{
"valueString" : "NY"
}
]
}
]
},
{
"linkId" : "receive-wic",
"text" : "Did you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?",
"answer" : [
{
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "N",
"display" : "No"
}
}
]
},
{
"linkId" : "mothers-height",
"text" : "What is your height?",
"item" : [
{
"linkId" : "mothers-height-inches",
"text" : "Inches",
"answer" : [
{
"valueQuantity" : {
"value" : 65,
"unit" : "[in_i]",
"system" : "http://unitsofmeasure.org",
"code" : "[in_i]"
}
}
]
}
]
},
{
"linkId" : "mothers-prepregnancy-weight",
"text" : "lbs",
"answer" : [
{
"valueQuantity" : {
"value" : 180,
"unit" : "[lb_av]",
"system" : "http://unitsofmeasure.org",
"code" : "[lb_av]"
}
}
]
},
{
"linkId" : "mothers-smoking",
"text" : "How many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.",
"item" : [
{
"linkId" : "mothers-smoking-3-months-prior",
"text" : "Three months before pregnancy",
"item" : [
{
"linkId" : "mothers-smoking-3-months-prior-cig",
"text" : "# of cigarettes*",
"answer" : [
{
"valueInteger" : 0
}
]
},
{
"linkId" : "mothers-smoking-3-months-prior-pck",
"text" : "# of packs",
"answer" : [
{
"valueInteger" : 0
}
]
}
]
},
{
"linkId" : "mothers-smoking-trimester-1",
"text" : "First three months of pregnancy",
"item" : [
{
"linkId" : "mothers-smoking-trimester-1-cig",
"text" : "# of cigarettes*",
"answer" : [
{
"valueInteger" : 0
}
]
},
{
"linkId" : "mothers-smoking-trimester-1-pck",
"text" : "# of packs",
"answer" : [
{
"valueInteger" : 0
}
]
}
]
},
{
"linkId" : "mothers-smoking-trimester-2",
"text" : "Second three months of pregnancy",
"item" : [
{
"linkId" : "mothers-smoking-trimester-2-cig",
"text" : "# of cigarettes*",
"answer" : [
{
"valueInteger" : 0
}
]
},
{
"linkId" : "mothers-smoking-trimester-2-pck",
"text" : "# of packs",
"answer" : [
{
"valueInteger" : 0
}
]
}
]
},
{
"linkId" : "mothers-smoking-trimester-3",
"text" : "Third trimester of pregnancy",
"item" : [
{
"linkId" : "mothers-smoking-trimester-3-cig",
"text" : "# of cigarettes*",
"answer" : [
{
"valueInteger" : 0
}
]
},
{
"linkId" : "mothers-smoking-trimester-3-pck",
"text" : "# of packs",
"answer" : [
{
"valueInteger" : 0
}
]
}
]
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Practitioner/practitioner-vital-records-janet-seito",
"resource" : {
"resourceType" : "Practitioner",
"id" : "practitioner-vital-records-janet-seito",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Practitioner-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_practitioner-vital-records-janet-seito\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner-vital-records-janet-seito</b></p><a name=\"practitioner-vital-records-janet-seito\"> </a><a name=\"hcpractitioner-vital-records-janet-seito\"> </a><a name=\"hcpractitioner-vital-records-janet-seito-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">NPI</a>/223347044</p><p><b>name</b>: Avery Jones </p><h3>Qualifications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://snomed.info/sct 76231001}\">Osteopath (occupation)</span></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "223347044"
}
],
"name" : [
{
"family" : "Jones",
"given" : [
"Avery"
],
"suffix" : [
"M.D."
]
}
],
"qualification" : [
// Using the osteo code until PhinVads updates the value set with an active code for Medical Doctor
{
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "76231001",
"display" : "Osteopath (occupation)"
}
]
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Location/location-south-hospital",
"resource" : {
"resourceType" : "Location",
"id" : "location-south-hospital",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_location-south-hospital\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location location-south-hospital</b></p><a name=\"location-south-hospital\"> </a><a name=\"hclocation-south-hospital\"> </a><a name=\"hclocation-south-hospital-en-US\"> </a><p><b>status</b>: Active</p><p><b>name</b>: South Hospital</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p></div>"
},
"status" : "active",
"name" : "South Hospital",
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "HOSP",
"display" : "Hospital"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Organization/organization-south-hospital",
"resource" : {
"resourceType" : "Organization",
"id" : "organization-south-hospital",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_organization-south-hospital\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization organization-south-hospital</b></p><a name=\"organization-south-hospital\"> </a><a name=\"hcorganization-south-hospital\"> </a><a name=\"hcorganization-south-hospital-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.0.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">NPI</a>/5555512</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p><p><b>name</b>: South Hospital</p><p><b>telecom</b>: <a href=\"tel:+1-555-555-1111\">+1-555-555-1111</a>, <a href=\"mailto:mail@southhospital.com\">mail@southhospital.com</a></p><p><b>address</b>: 2100 North Ave Salt Lake City UT 84116 US </p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "5555512"
}
],
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "HOSP",
"display" : "Hospital"
}
]
}
],
"name" : "South Hospital",
"telecom" : [
{
"system" : "phone",
"value" : "+1-555-555-1111"
},
{
"system" : "email",
"value" : "mail@southhospital.com"
}
],
"address" : [
{
"line" : [
"2100 North Ave"
],
"city" : "Salt Lake City",
"state" : "UT",
"postalCode" : "84116",
"country" : "US"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/RelatedPerson/relatedperson-mother-carmen-teresa-lee",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "relatedperson-mother-carmen-teresa-lee",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/RelatedPerson-mother-gestational-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_relatedperson-mother-carmen-teresa-lee\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson relatedperson-mother-carmen-teresa-lee</b></p><a name=\"relatedperson-mother-carmen-teresa-lee\"> </a><a name=\"hcrelatedperson-mother-carmen-teresa-lee\"> </a><a name=\"hcrelatedperson-mother-carmen-teresa-lee-en-US\"> </a><p><b>active</b>: true</p><p><b>patient</b>: <a href=\"Patient-patient-decedent-fetus-not-named.html\">Patient - Decedent Fetus (Fetus Not Named)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode GESTM}\">Gestational Mother</span></p><p><b>name</b>: Carmen Teresa Lee (Official)</p><p><b>gender</b>: Female</p><p><b>birthDate</b>: 1986-02-15</p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2054-5",
"display" : "Black or African American"
}
},
{
"url" : "text",
"valueString" : "Black or African America"
}
]
},
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2135-2",
"display" : "Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Hispanic or Latino"
}
]
}
],
"active" : true,
"patient" : {
🔗 "reference" : "Patient/patient-decedent-fetus-not-named",
"display" : "Patient - Decedent Fetus (Fetus Not Named)"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "GESTM",
"display" : "gestational mother"
}
],
"text" : "Gestational Mother"
}
],
"name" : [
{
"use" : "official",
"family" : "Lee",
"given" : [
"Carmen",
"Teresa"
]
}
],
"gender" : "female",
"birthDate" : "1986-02-15"
}
}
]
}
IG © 2020+ IHE International. Package ihe.qrph.bfdr#1.1.0 based on FHIR 4.0.1. Generated 2024-07-09
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