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-live-birth-babyg-quinn",
"meta" : {
"versionId" : "4",
"lastUpdated" : "2023-07-07T02:39:35.768Z",
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Bundle-document-bfdr"
]
},
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:18825bb1-1acb-48c4-9b45-baa612640ba5"
},
"type" : "document",
"timestamp" : "2019-02-11T02:05:44.434Z",
"entry" : [
{
"fullUrl" : "http://example.org/fhir/Composition/composition-provider-live-birth-babyg-quinn",
"resource" : {
"resourceType" : "Composition",
"id" : "composition-provider-live-birth-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Composition-provider-live-birth-report"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_composition-provider-live-birth-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition composition-provider-live-birth-babyg-quinn</b></p><a name=\"composition-provider-live-birth-babyg-quinn\"> </a><a name=\"hccomposition-provider-live-birth-babyg-quinn\"> </a><a name=\"hccomposition-provider-live-birth-babyg-quinn-en-US\"> </a><p><b>identifier</b>: a03eab8c-11e8-4d0c-ad2a-b385395e27de</p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 68998-4}\">U.S. standard certificate of live birth - 2003 revision</span></p><p><b>encounter</b>: <a href=\"Encounter-encounter-birth-babyg-quinn.html\">Encounter - Birth (Baby G Quinn)</a></p><p><b>date</b>: 2019-02-12</p><p><b>author</b>: <a href=\"Practitioner-practitioner-vital-records-avery-jones.html\">Practitioner - Vital Records (Dr. Avery Jones, MD)</a></p><p><b>title</b>: Provider supplied live birth report Document</p></div>"
},
"extension" : [
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-certificate-number",
"valueIdentifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "BCT"
}
]
},
"value" : "15075"
}
},
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-local-file-number",
"valueIdentifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "BCFN"
}
]
},
"value" : "444455555"
}
},
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-filed-by-registrar",
"valueDateTime" : "2019-02-12"
}
],
"identifier" : {
"value" : "a03eab8c-11e8-4d0c-ad2a-b385395e27de"
},
"status" : "final",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68998-4",
"display" : "U.S. standard certificate of live birth - 2003 revision"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "Patient - Child (Baby G Quinn)"
},
"encounter" : {
🔗 "extension" : [
{
"url" : "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-encounter-maternity-reference",
"valueReference" : {
🔗 "reference" : "Encounter/encounter-maternity-jada-ann-quinn"
}
}
],
"reference" : "Encounter/encounter-birth-babyg-quinn",
"display" : "Encounter - Birth (Baby G Quinn)"
},
"date" : "2019-02-12",
"author" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-avery-jones",
"display" : "Practitioner - Vital Records (Dr. Avery Jones, MD)"
}
],
"title" : "Provider supplied live birth report Document",
"section" : [
{
"title" : "Mother (prenatal) Section on the Live Birth Certificate",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57073-9",
"display" : "Prenatal records"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-planned-to-deliver-at-home-babyg-quinn",
"display" : "Observation - Planned to Deliver at Home (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-date-of-first-prenatal-care-visit-jada-ann-quinn",
"display" : "Observation - Date of First Prenantal Care Visit (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-number-prenatal-visits-jada-ann-quinn",
"display" : "Observation - Number Prenatal Visits (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-last-menstrual-period-jada-ann-quinn",
"display" : "Observation - Last Menstrual Period (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-number-births-now-living-jada-ann-quinn",
"display" : "Observation - Number Births Now Living (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-number-births-now-dead-jada-ann-quinn",
"display" : "Observation - Number Births Now Dead (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-date-of-last-live-birth-jada-ann-quinn",
"display" : "Observation - Date of Last Live Birth (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-number-other-pregnancy-outcomes-jada-ann-quinn",
"display" : "Observation - Number Other Pregnancy Outcomes (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn",
"display" : "Observation - Date of Last Other Pregnancy Outcome (Jada Ann Quinn)"
},
{
🔗 "reference" : "Coverage/coverage-principal-payer-for-delivery-jada-ann-quinn",
"display" : "Coverage - Principal Payer for Delivery (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-mother-delivery-weight-jada-ann-quinn",
"display" : "Observation - Mother Delivery Weight (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-mother-height-jada-ann-quinn",
"display" : "Observation - Observation - Mother Height (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-mother-prepregnancy-weight-jada-ann-quinn",
"display" : "Observation - Mother Prepregnancy Weight (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-mother-received-wic-food-jada-ann-quinn",
"display" : "Observation - Mother Received WIC Food (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-1-jada-ann-quinn",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (3 months prior: Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-2-jada-ann-quinn",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (first 3 months: Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-3-jada-ann-quinn",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (second 3 months: Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-cig-smoking-pregnancy-4-jada-ann-quinn",
"display" : "Observation - Cigarette Smoking Before/During Pregnancy (last 3 months: Jada Ann Quinn)"
}
]
},
{
"title" : "Medical Health Information Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "55752-0",
"display" : "Clinical information"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"entry" : [
{
🔗 "reference" : "Condition/condition-prepregnancy-diabetes-jada-ann-quinn",
"display" : "Condition - Prepregnancy Diabetes - Jada Ann Quinn"
},
{
🔗 "reference" : "Condition/condition-gestational-hypertension-jada-ann-quinn",
"display" : "Observation - Pregnancy Risk Factor (Jada Ann Quinn: Pregnancy-induced hypertension)"
},
{
🔗 "reference" : "Observation/observation-number-previous-cesareans-jada-ann-quinn",
"display" : "Observation - Number Previous Cesareans (Jada Ann Quinn)"
},
{
🔗 "reference" : "Condition/condition-infection-present-during-pregnancy-jada-ann-quinn",
"display" : "Condition - Infection Present During Pregnancy (Jada Ann Quinn)"
},
{
🔗 "reference" : "Procedure/procedure-obstetric-procedure-jada-ann-quinn",
"display" : "Procedure - Obstetric Procedure (Jada Ann Quinn)"
},
{
🔗 "reference" : "Condition/condition-chorioamnionitis-jada-ann-quinn",
"display" : "Condition - Characteristic of Labor and Delivery (Jada Ann Quinn: Chorioamnionitis)"
},
{
🔗 "reference" : "Procedure/procedure-induction-of-labor-jada-ann-quinn",
"display" : "Procedure - Characteristic of Labor and Delivery (Jada Ann Quinn: Induction of Labor)"
},
{
🔗 "reference" : "Observation/observation-fetal-presentation-babyg-quinn",
"display" : "Observation - Fetal Presentation (Baby G Quinn)"
},
{
🔗 "reference" : "Procedure/procedure-final-route-method-delivery-babyg-quinn",
"display" : "Procedure - Final Route and Method of Delivery (Baby G Quinn)"
},
{
🔗 "reference" : "Condition/condition-ruptured-uterus-jada-ann-quinn",
"display" : "Condition - Maternal Morbidity - Ruptured Uterus (Jada Ann Quinn)"
}
]
},
{
"title" : "Newborn section on the Live Birth Certificate",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57075-4",
"display" : "Newborn delivery information"
}
]
},
"entry" : [
{
🔗 "reference" : "Observation/observation-birth-weight-babyg-quinn",
"display" : "Observation - Birth Weight (Baby G Quinn)"
},
{
🔗 "reference" : "Observation/observation-gestational-age-at-delivery-babyg-quinn",
"display" : "Observation - Gestational Age at Delivery (Baby G Quinn)"
},
{
🔗 "reference" : "Observation/observation-apgar-score-babyg-quinn-1-min",
"display" : "Observation - Apgar Score (BabyG Quinn: 1 min)"
},
{
🔗 "reference" : "Observation/observation-apgar-score-babyg-quinn-5-min",
"display" : "Observation - Apgar Score (BabyG Quinn: 5 min)"
},
{
🔗 "reference" : "Condition/condition-congenital-anomaly-of-newborn-babyg-quinn",
"display" : "Condition - Congenital Anomaly of Newborn (BabyG Quinn) 1"
},
{
🔗 "reference" : "Condition/condition-congenital-anomaly-of-newborn-babyg-quinn-2",
"display" : "Condition - Congenital Anomaly of Newborn (Baby G Quinn) 2"
},
{
🔗 "reference" : "Observation/observation-infant-living-babyg-quinn",
"display" : "Observation - Infant Living (Baby G Quinn)"
},
{
🔗 "reference" : "Observation/observation-infant-breastfed-at-discharge-babyg-quinn",
"display" : "Observation - Infant Breastfed at Discharge (Baby G Quinn)"
}
]
},
{
"title" : "Mother's Information Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "92014-0",
"display" : "Mother's administrative information"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-mother-married-during-pregnancy-jada-ann-quinn",
"display" : "Observation - Mother Married During Pregnancy (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-parent-education-level-jada-ann-quinn",
"display" : "Observation - Parent Education Level (Jada Ann Quinn)"
},
{
🔗 "reference" : "Observation/observation-ssn-requested-for-child-babyg-quinn",
"display" : "Observation - SSN Requested for Child (Jada Ann Quinn)"
}
]
},
{
"title" : "Father's Information Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "92013-2",
"display" : "Father's Administrative Information"
}
]
},
"focus" : {
🔗 "reference" : "RelatedPerson/relatedperson-father-natural-james-brandon-quinn",
"display" : "RelatedPerson - Father (James Brandon Quinn)"
},
"entry" : [
{
🔗 "reference" : "Observation/observation-paternity-acknowledgement-signed-james-quinn",
"display" : "Observation - Paternity Acknowledgement Signed (James Brandon Quinn)"
},
{
🔗 "reference" : "Observation/observation-parent-education-level-james-quinn",
"display" : "Observation - Parent Education Level (James Brandon Quinn)"
}
]
},
{
"title" : "Mother's QuestionnaireResponse Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "74465-6",
"display" : "Questionnaire response Document"
}
]
},
"focus" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"entry" : [
{
🔗 "reference" : "QuestionnaireResponse/QuestionnaireResponse-mothers-live-birth-jada-quinn",
"display" : "QuestionnaireResponse - Mother's Worksheet for Live Birth Certificate"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Patient/patient-child-babyg-quinn",
"resource" : {
"resourceType" : "Patient",
"id" : "patient-child-babyg-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-child-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient-child-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-child-babyg-quinn</b></p><a name=\"patient-child-babyg-quinn\"> </a><a name=\"hcpatient-child-babyg-quinn\"> </a><a name=\"hcpatient-child-babyg-quinn-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Baby G Quinn Female, DoB: 2019-02-12 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><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-2186-5\">Race & Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</li><li>text: Not 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\">Salt Lake City UT </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-2106-3\">Race & Ethnicity - CDC</a> 2106-3: White</li><li>text: White</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" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
]
},
{
"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" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not 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" : {
"city" : "Salt Lake City",
"district" : "Salt Lake",
"state" : "UT"
}
}
],
"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" : "Quinn",
"given" : [
"Baby",
"G"
]
}
],
"gender" : "female",
"birthDate" : "2019-02-12",
"_birthDate" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/patient-birthTime",
"valueDateTime" : "2019-02-12T13:00:00-07:00"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Encounter/encounter-birth-babyg-quinn",
"resource" : {
"resourceType" : "Encounter",
"id" : "encounter-birth-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Encounter-birth"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_encounter-birth-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter-birth-babyg-quinn</b></p><a name=\"encounter-birth-babyg-quinn\"> </a><a name=\"hcencounter-birth-babyg-quinn\"> </a><a name=\"hcencounter-birth-babyg-quinn-en-US\"> </a><p><b>identifier</b>: <code>http://hospital.smarthealthit.org</code>/9937012</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-child-babyg-quinn.html\">BabyG Quinn</a></p><blockquote><p><b>participant</b></p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 87287-9}\">Birth certifier [Extended Identifier]</span></p><p><b>period</b>: 2019-02-12 13:30:00-0700 --> (ongoing)</p><p><b>individual</b>: <a href=\"Practitioner-practitioner-vital-records-avery-jones.html\">Practitioner - Vital Records (Avery Jones, MD)</a></p></blockquote><blockquote><p><b>participant</b></p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 87286-1}\">Birth attendant [Extended Identifier]</span></p><p><b>individual</b>: <a href=\"Practitioner-practitioner-vital-records-avery-jones.html\">Practitioner - Vital Records (Avery Jones, MD)</a></p></blockquote><p><b>period</b>: 2019-02-12 13:00:00-0700 --> 2019-02-15 10:00:00-0700</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Destination</b></td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Location-location-east-hospital.html\">East Hospital Location</a></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/discharge-disposition other-hcf}\">The patient was transferred to another healthcare facility.</span></td></tr></table><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>partOf</b>: <a href=\"Encounter-encounter-maternity-jada-ann-quinn.html\">Maternity Encounter - Jada Ann Quinn</a></p></div>"
},
"identifier" : [
{
"system" : "http://hospital.smarthealthit.org",
"value" : "9937012"
}
],
"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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"participant" : [
{
"type" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87287-9",
"display" : "Birth certifier [Extended Identifier]"
}
]
}
],
"period" : {
"start" : "2019-02-12T13:30:00-07:00"
},
"individual" : {
🔗 "reference" : "Practitioner/practitioner-vital-records-avery-jones",
"display" : "Practitioner - Vital Records (Avery Jones, MD)"
}
},
{
"type" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87286-1",
"display" : "Birth attendant [Extended Identifier]"
}
]
}
],
"individual" : {
🔗 "reference" : "Practitioner/practitioner-vital-records-avery-jones",
"display" : "Practitioner - Vital Records (Avery Jones, MD)"
}
}
],
"period" : {
"start" : "2019-02-12T13:00:00-07:00",
"end" : "2019-02-15T10:00:00-07:00"
},
"hospitalization" : {
"destination" : {
🔗 "reference" : "Location/location-east-hospital",
"display" : "East Hospital Location"
},
"dischargeDisposition" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/discharge-disposition",
"code" : "other-hcf",
"display" : "Other healthcare facility"
}
],
"text" : "The patient was transferred to another healthcare facility."
}
},
"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"
}
]
}
}
],
"partOf" : {
🔗 "reference" : "Encounter/encounter-maternity-jada-ann-quinn",
"display" : "Maternity Encounter - Jada Ann Quinn"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Encounter/encounter-maternity-jada-ann-quinn",
"resource" : {
"resourceType" : "Encounter",
"id" : "encounter-maternity-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter encounter-maternity-jada-ann-quinn</b></p><a name=\"encounter-maternity-jada-ann-quinn\"> </a><a name=\"hcencounter-maternity-jada-ann-quinn\"> </a><a name=\"hcencounter-maternity-jada-ann-quinn-en-US\"> </a><p><b>identifier</b>: <code>http://hospital.smarthealthit.org</code>/9937012</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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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-avery-jones.html\">Practitioner - Vital Records (Avery Jones, MD)</a></td></tr></table><p><b>period</b>: 2019-02-11 10:00:00-0700 --> 2019-02-15 10:00:00-0700</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Origin</b></td><td><b>AdmitSource</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Location-location-north-hospital.html\">Location - US Core Location (North Hospital)</a></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/admit-source hosp-trans}\">The Patient has been transferred from another hospital for this encounter.</span></td></tr></table><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" : "9937012"
}
],
"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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"participant" : [
{
"type" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87286-1",
"display" : "Birth attendant [Extended Identifier]"
}
]
}
],
"individual" : {
🔗 "reference" : "Practitioner/practitioner-vital-records-avery-jones",
"display" : "Practitioner - Vital Records (Avery Jones, MD)"
}
}
],
"period" : {
"start" : "2019-02-11T10:00:00-07:00",
"end" : "2019-02-15T10:00:00-07:00"
},
"hospitalization" : {
"origin" : {
🔗 "reference" : "Location/location-north-hospital",
"display" : "Location - US Core Location (North Hospital)"
},
"admitSource" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/admit-source",
"code" : "hosp-trans",
"display" : "Transferred from other hospital"
}
],
"text" : "The Patient has been transferred from another hospital for this encounter."
}
},
"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-avery-jones",
"resource" : {
"resourceType" : "Practitioner",
"id" : "practitioner-vital-records-avery-jones",
"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-avery-jones\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner practitioner-vital-records-avery-jones</b></p><a name=\"practitioner-vital-records-avery-jones\"> </a><a name=\"hcpractitioner-vital-records-avery-jones\"> </a><a name=\"hcpractitioner-vital-records-avery-jones-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>/112247003</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" : "112247003"
}
],
"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/Patient/patient-mother-jada-ann-quinn",
"resource" : {
"resourceType" : "Patient",
"id" : "patient-mother-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient patient-mother-jada-ann-quinn</b></p><a name=\"patient-mother-jada-ann-quinn\"> </a><a name=\"hcpatient-mother-jada-ann-quinn\"> </a><a name=\"hcpatient-mother-jada-ann-quinn-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Social Security number/132225986\u00a0(use:\u00a0usual,\u00a0)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Alternate names (see the one above)\">Alt. Name:</td><td colspan=\"3\">Jada Ann King (Name changed for Marriage)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 1-(404)555-1212(Home)</li><li><a href=\"mailto:jadaann.quinn@example.com\">jadaann.quinn@example.com</a></li><li>1875 West Morton Avenue Salt Lake City UT 84116 US (home)</li><li>1848 South 1300 East Salt Lake City UT 84401 US (billing)</li></ul></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-jada-ann-quinn.html\">RelatedPerson Jada Ann Quinn (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-2186-5\">Race & Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</li><li>text: Not 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\">UT </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-2106-3\">Race & Ethnicity - CDC</a> 2106-3: White</li><li>ombCategory: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-1002-5\">Race & Ethnicity - CDC</a> 1002-5: American Indian or Alaska Native</li><li>text: White, American Indian or Alaska Native</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" : "2106-3",
"display" : "White"
}
},
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "1002-5",
"display" : "American Indian or Alaska Native"
}
},
{
"url" : "text",
"valueString" : "White, American Indian or Alaska Native"
}
]
},
{
"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" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not 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" : "UT"
}
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "SS",
"display" : "Social Security number"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-ssn",
"value" : "132225986"
},
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hospital.smarthealthit.org",
"value" : "1032702"
}
],
"name" : [
{
"use" : "official",
"family" : "Quinn",
"given" : [
"Jada",
"Ann"
]
},
{
"use" : "maiden",
"family" : "King",
"given" : [
"Jada",
"Ann"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "1-(404)555-1212",
"use" : "home"
},
{
"system" : "email",
"value" : "jadaann.quinn@example.com"
}
],
"gender" : "female",
"birthDate" : "1985-01-15",
"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" : "Y",
"display" : "Yes"
}
}
],
"use" : "home",
"line" : [
"1875 West Morton Avenue"
],
"city" : "Salt Lake City",
"district" : "Salt Lake",
"state" : "UT",
"postalCode" : "84116",
"country" : "US"
},
{
"use" : "billing",
"line" : [
"1848 South 1300 East"
],
"city" : "Salt Lake City",
"state" : "UT",
"postalCode" : "84401",
"country" : "US"
}
],
"link" : [
{
"other" : {
🔗 "reference" : "RelatedPerson/relatedperson-mother-jada-ann-quinn"
},
"type" : "seealso"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-planned-to-deliver-at-home-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-planned-to-deliver-at-home-babyg-quinn",
"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-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-planned-to-deliver-at-home-babyg-quinn</b></p><a name=\"observation-planned-to-deliver-at-home-babyg-quinn\"> </a><a name=\"hcobservation-planned-to-deliver-at-home-babyg-quinn\"> </a><a name=\"hcobservation-planned-to-deliver-at-home-babyg-quinn-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-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: true</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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-date-of-first-prenatal-care-visit-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-date-of-first-prenatal-care-visit-jada-ann-quinn</b></p><a name=\"observation-date-of-first-prenatal-care-visit-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-first-prenatal-care-visit-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-first-prenatal-care-visit-jada-ann-quinn-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-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 2018-07-20</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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2018-07-20"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-prenatal-visits-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-prenatal-visits-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-prenatal-visits-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-number-prenatal-visits-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-prenatal-visits-jada-ann-quinn</b></p><a name=\"observation-number-prenatal-visits-jada-ann-quinn\"> </a><a name=\"hcobservation-number-prenatal-visits-jada-ann-quinn\"> </a><a name=\"hcobservation-number-prenatal-visits-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 68493-6}\">Prenatal visits for this pregnancy #</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 8</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68493-6",
"display" : "Prenatal visits for this pregnancy #"
}
],
"text" : "Prenatal visits for this pregnancy #"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 8
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-last-menstrual-period-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-last-menstrual-period-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-last-menstrual-period-jada-ann-quinn</b></p><a name=\"observation-last-menstrual-period-jada-ann-quinn\"> </a><a name=\"hcobservation-last-menstrual-period-jada-ann-quinn\"> </a><a name=\"hcobservation-last-menstrual-period-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 2018-06-05</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2018-06-05"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-births-now-living-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-births-now-living-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-births-now-living-jada-ann-quinn</b></p><a name=\"observation-number-births-now-living-jada-ann-quinn\"> </a><a name=\"hcobservation-number-births-now-living-jada-ann-quinn\"> </a><a name=\"hcobservation-number-births-now-living-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"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-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-births-now-dead-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-births-now-dead-jada-ann-quinn</b></p><a name=\"observation-number-births-now-dead-jada-ann-quinn\"> </a><a name=\"hcobservation-number-births-now-dead-jada-ann-quinn\"> </a><a name=\"hcobservation-number-births-now-dead-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"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-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-date-of-last-live-birth-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-date-of-last-live-birth-jada-ann-quinn</b></p><a name=\"observation-date-of-last-live-birth-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-last-live-birth-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-last-live-birth-jada-ann-quinn-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-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 2014-11-20</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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2014-11-20"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-other-pregnancy-outcomes-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-other-pregnancy-outcomes-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-other-pregnancy-outcomes-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-number-other-pregnancy-outcomes-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-other-pregnancy-outcomes-jada-ann-quinn</b></p><a name=\"observation-number-other-pregnancy-outcomes-jada-ann-quinn\"> </a><a name=\"hcobservation-number-other-pregnancy-outcomes-jada-ann-quinn\"> </a><a name=\"hcobservation-number-other-pregnancy-outcomes-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69043-8}\">Other pregnancy outcomes #</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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" : "69043-8",
"display" : "Other pregnancy outcomes #"
}
],
"text" : "Other pregnancy outcomes #"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-last-other-pregnancy-outcome"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn</b></p><a name=\"observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-last-other-pregnancy-outcome-jada-ann-quinn\"> </a><a name=\"hcobservation-date-of-last-other-pregnancy-outcome-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 68500-8}\">Date of last other pregnancy outcome</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 2015-05</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "68500-8",
"display" : "Date last other pregnancy outcome"
}
],
"text" : "Date of last other pregnancy outcome"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueDateTime" : "2015-05"
}
},
{
"fullUrl" : "http://example.org/fhir/Coverage/coverage-principal-payer-for-delivery-jada-ann-quinn",
"resource" : {
"resourceType" : "Coverage",
"id" : "coverage-principal-payer-for-delivery-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Coverage-principal-payer-for-delivery"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_coverage-principal-payer-for-delivery-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage coverage-principal-payer-for-delivery-jada-ann-quinn</b></p><a name=\"coverage-principal-payer-for-delivery-jada-ann-quinn\"> </a><a name=\"hccoverage-principal-payer-for-delivery-jada-ann-quinn\"> </a><a name=\"hccoverage-principal-payer-for-delivery-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://nahdo.org/sopt 5}\">Private Health Insurance</span></p><p><b>beneficiary</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>payor</b>: Not asked</p></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "https://nahdo.org/sopt",
"code" : "5",
"display" : "PRIVATE HEALTH INSURANCE"
}
],
"text" : "Private Health Insurance"
},
"beneficiary" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"payor" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode" : "not-asked"
}
],
"display" : "Not asked"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-delivery-weight-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-delivery-weight-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-delivery-weight-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-mother-delivery-weight-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-delivery-weight-jada-ann-quinn</b></p><a name=\"observation-mother-delivery-weight-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-delivery-weight-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-delivery-weight-jada-ann-quinn-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 69461-2}\">Mother's body weight --at delivery</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-02-12</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 175 [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" : "69461-2",
"display" : "Mother's body weight --at delivery"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-02-12",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 175,
"system" : "http://unitsofmeasure.org",
"code" : "[lb_av]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-height-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-height-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-height-jada-ann-quinn</b></p><a name=\"observation-mother-height-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-height-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-height-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: 67 [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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-02-10",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 67,
"system" : "http://unitsofmeasure.org",
"code" : "[in_i]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-prepregnancy-weight-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-prepregnancy-weight-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-prepregnancy-weight-jada-ann-quinn</b></p><a name=\"observation-mother-prepregnancy-weight-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-prepregnancy-weight-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-prepregnancy-weight-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-06-20</p><p><b>performer</b>: <a href=\"Practitioner-practitioner-vital-records-janet-seito.html\">Practitioner Avery Jones </a></p><p><b>value</b>: 145 [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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-06-20",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 145,
"system" : "http://unitsofmeasure.org",
"code" : "[lb_av]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-received-wic-food-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-received-wic-food-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-received-wic-food-jada-ann-quinn</b></p><a name=\"observation-mother-received-wic-food-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-received-wic-food-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-received-wic-food-jada-ann-quinn-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-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}\">Yes</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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "Y",
"display" : "Yes"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-1-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-1-jada-ann-quinn</b></p><a name=\"observation-cig-smoking-pregnancy-1-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-1-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-1-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>focus</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 20</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueInteger" : 20
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-2-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-2-jada-ann-quinn</b></p><a name=\"observation-cig-smoking-pregnancy-2-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-2-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-2-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>focus</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: 3</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueInteger" : 3
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-3-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-3-jada-ann-quinn</b></p><a name=\"observation-cig-smoking-pregnancy-3-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-3-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-3-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>focus</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueInteger" : 1
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-cig-smoking-pregnancy-4-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-cig-smoking-pregnancy-4-jada-ann-quinn</b></p><a name=\"observation-cig-smoking-pregnancy-4-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-4-jada-ann-quinn\"> </a><a name=\"hcobservation-cig-smoking-pregnancy-4-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>focus</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueInteger" : 0
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-prepregnancy-diabetes-jada-ann-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-prepregnancy-diabetes-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-prepregnancy-diabetes-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-prepregnancy-diabetes-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-prepregnancy-diabetes-jada-ann-quinn</b></p><a name=\"condition-prepregnancy-diabetes-jada-ann-quinn\"> </a><a name=\"hccondition-prepregnancy-diabetes-jada-ann-quinn\"> </a><a name=\"hccondition-prepregnancy-diabetes-jada-ann-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 73211009}\">Diabetes mellitus (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>onset</b>: 2015-02-12</p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "73211009",
"display" : "Diabetes mellitus (disorder)"
}
],
"text" : "Diabetes mellitus (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"onsetDateTime" : "2015-02-12"
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-gestational-hypertension-jada-ann-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-gestational-hypertension-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-gestational-hypertension-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-gestational-hypertension-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-gestational-hypertension-jada-ann-quinn</b></p><a name=\"condition-gestational-hypertension-jada-ann-quinn\"> </a><a name=\"hccondition-gestational-hypertension-jada-ann-quinn\"> </a><a name=\"hccondition-gestational-hypertension-jada-ann-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 48194001}\">Pregnancy-induced hypertension (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "48194001",
"display" : "Pregnancy-induced hypertension (disorder)"
}
],
"text" : "Pregnancy-induced hypertension (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-number-previous-cesareans-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-number-previous-cesareans-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-number-previous-cesareans-jada-ann-quinn</b></p><a name=\"observation-number-previous-cesareans-jada-ann-quinn\"> </a><a name=\"hcobservation-number-previous-cesareans-jada-ann-quinn\"> </a><a name=\"hcobservation-number-previous-cesareans-jada-ann-quinn-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-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 1
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-infection-present-during-pregnancy-jada-ann-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-infection-present-during-pregnancy-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-infection-present-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-infection-present-during-pregnancy-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-infection-present-during-pregnancy-jada-ann-quinn</b></p><a name=\"condition-infection-present-during-pregnancy-jada-ann-quinn\"> </a><a name=\"hccondition-infection-present-during-pregnancy-jada-ann-quinn\"> </a><a name=\"hccondition-infection-present-during-pregnancy-jada-ann-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span>, <span title=\"Codes:{http://loinc.org 72519-2}\">Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth]</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 105629000}\">Chlamydial infection (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
]
},
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "72519-2",
"display" : "Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth]"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "105629000",
"display" : "Chlamydial infection (disorder)"
}
],
"text" : "Chlamydial infection (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/procedure-obstetric-procedure-jada-ann-quinn",
"resource" : {
"resourceType" : "Procedure",
"id" : "procedure-obstetric-procedure-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-obstetric"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_procedure-obstetric-procedure-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure procedure-obstetric-procedure-jada-ann-quinn</b></p><a name=\"procedure-obstetric-procedure-jada-ann-quinn\"> </a><a name=\"hcprocedure-obstetric-procedure-jada-ann-quinn\"> </a><a name=\"hcprocedure-obstetric-procedure-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 240278000}\">External cephalic version: Failed</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>performed</b>: 2019-02-07 08:30:00-0700 --> 2019-02-07 08:45:00-0700</p><p><b>outcome</b>: <span title=\"Codes:{http://snomed.info/sct 385671000}\">External cephalic version: Unsuccessful</span></p></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "240278000",
"display" : "External cephalic version (procedure)"
}
],
"text" : "External cephalic version: Failed"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"performedPeriod" : {
"start" : "2019-02-07T08:30:00-07:00",
"end" : "2019-02-07T08:45:00-07:00"
},
"outcome" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "385671000",
"display" : "Unsuccessful"
}
],
"text" : "External cephalic version: Unsuccessful"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-chorioamnionitis-jada-ann-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-chorioamnionitis-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-chorioamnionitis"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-chorioamnionitis-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-chorioamnionitis-jada-ann-quinn</b></p><a name=\"condition-chorioamnionitis-jada-ann-quinn\"> </a><a name=\"hccondition-chorioamnionitis-jada-ann-quinn\"> </a><a name=\"hccondition-chorioamnionitis-jada-ann-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 11612004}\">Chorioamnionitis (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "11612004",
"display" : "Chorioamnionitis (disorder)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/procedure-induction-of-labor-jada-ann-quinn",
"resource" : {
"resourceType" : "Procedure",
"id" : "procedure-induction-of-labor-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-induction-of-labor"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_procedure-induction-of-labor-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure procedure-induction-of-labor-jada-ann-quinn</b></p><a name=\"procedure-induction-of-labor-jada-ann-quinn\"> </a><a name=\"hcprocedure-induction-of-labor-jada-ann-quinn\"> </a><a name=\"hcprocedure-induction-of-labor-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 236958009}\">Induction of labor (procedure)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>performed</b>: 2019-02-07 08:30:00-0700 --> 2019-02-07 08:45:00-0700</p></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "236958009",
"display" : "Induction of labor (procedure)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"performedPeriod" : {
"start" : "2019-02-07T08:30:00-07:00",
"end" : "2019-02-07T08:45:00-07:00"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-fetal-presentation-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-fetal-presentation-babyg-quinn",
"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-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-fetal-presentation-babyg-quinn</b></p><a name=\"observation-fetal-presentation-babyg-quinn\"> </a><a name=\"hcobservation-fetal-presentation-babyg-quinn\"> </a><a name=\"hcobservation-fetal-presentation-babyg-quinn-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-child-babyg-quinn.html\">Patient - Child (Baby G Quinn)</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-child-babyg-quinn",
"display" : "Patient - Child (Baby G Quinn)"
},
"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-babyg-quinn",
"resource" : {
"resourceType" : "Procedure",
"id" : "procedure-final-route-method-delivery-babyg-quinn",
"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-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure procedure-final-route-method-delivery-babyg-quinn</b></p><a name=\"procedure-final-route-method-delivery-babyg-quinn\"> </a><a name=\"hcprocedure-final-route-method-delivery-babyg-quinn\"> </a><a name=\"hcprocedure-final-route-method-delivery-babyg-quinn-en-US\"> </a><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 11466000}\">Cesarean section</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>performed</b>: 2019-02-12 12:45:00-0700 --> 2019-02-12 13:15:00-0700</p><p><b>reasonReference</b>: <a href=\"Observation-observation-labor-trial-attempted-babyg-quinn.html\">Labor trial attempted - true</a></p></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "11466000",
"display" : "Cesarean section"
}
],
"text" : "Cesarean section"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"performedPeriod" : {
"start" : "2019-02-12T12:45:00-07:00",
"end" : "2019-02-12T13:15:00-07:00"
},
"reasonReference" : [
{
🔗 "reference" : "Observation/observation-labor-trial-attempted-babyg-quinn",
"display" : "Labor trial attempted - true"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-ruptured-uterus-jada-ann-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-ruptured-uterus-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-ruptured-uterus"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-ruptured-uterus-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-ruptured-uterus-jada-ann-quinn</b></p><a name=\"condition-ruptured-uterus-jada-ann-quinn\"> </a><a name=\"hccondition-ruptured-uterus-jada-ann-quinn\"> </a><a name=\"hccondition-ruptured-uterus-jada-ann-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 34430009}\">Rupture of uterus (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "34430009",
"display" : "Rupture of uterus (disorder)"
}
],
"text" : "Rupture of uterus (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-birth-weight-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-birth-weight-babyg-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-birth-weight-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-birth-weight-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-birth-weight-babyg-quinn</b></p><a name=\"observation-birth-weight-babyg-quinn\"> </a><a name=\"hcobservation-birth-weight-babyg-quinn\"> </a><a name=\"hcobservation-birth-weight-babyg-quinn-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-child-babyg-quinn.html\">BabyG Quinn</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>: 2500 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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-02-10",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 2500,
"system" : "http://unitsofmeasure.org",
"code" : "g"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-gestational-age-at-delivery-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-gestational-age-at-delivery-babyg-quinn",
"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-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-gestational-age-at-delivery-babyg-quinn</b></p><a name=\"observation-gestational-age-at-delivery-babyg-quinn\"> </a><a name=\"hcobservation-gestational-age-at-delivery-babyg-quinn\"> </a><a name=\"hcobservation-gestational-age-at-delivery-babyg-quinn-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-child-babyg-quinn.html\">BabyG Quinn</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>: 36 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-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueQuantity" : {
"value" : 36,
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-apgar-score-babyg-quinn-1-min",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-apgar-score-babyg-quinn-1-min",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-apgar-score-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-apgar-score-babyg-quinn-1-min\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-apgar-score-babyg-quinn-1-min</b></p><a name=\"observation-apgar-score-babyg-quinn-1-min\"> </a><a name=\"hcobservation-apgar-score-babyg-quinn-1-min\"> </a><a name=\"hcobservation-apgar-score-babyg-quinn-1-min-en-US\"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category survey}\">Survey</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 9272-6}\">1 minute Apgar Score</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</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>: 5</p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "survey",
"display" : "Survey"
}
],
"text" : "Survey"
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "9272-6",
"display" : "1 minute Apgar Score"
}
],
"text" : "1 minute Apgar Score"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 5
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-apgar-score-babyg-quinn-5-min",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-apgar-score-babyg-quinn-5-min",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-apgar-score-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-apgar-score-babyg-quinn-5-min\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-apgar-score-babyg-quinn-5-min</b></p><a name=\"observation-apgar-score-babyg-quinn-5-min\"> </a><a name=\"hcobservation-apgar-score-babyg-quinn-5-min\"> </a><a name=\"hcobservation-apgar-score-babyg-quinn-5-min-en-US\"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category survey}\">Survey</span></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 9274-2}\">5 minute Apgar Score</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</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>: 7</p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "survey",
"display" : "Survey"
}
],
"text" : "Survey"
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "9274-2",
"display" : "5 minute Apgar Score"
}
],
"text" : "5 minute Apgar Score"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueInteger" : 7
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-congenital-anomaly-of-newborn-babyg-quinn",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-congenital-anomaly-of-newborn-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-congenital-anomaly-of-newborn"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-congenital-anomaly-of-newborn-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-congenital-anomaly-of-newborn-babyg-quinn</b></p><a name=\"condition-congenital-anomaly-of-newborn-babyg-quinn\"> </a><a name=\"hccondition-congenital-anomaly-of-newborn-babyg-quinn\"> </a><a name=\"hccondition-congenital-anomaly-of-newborn-babyg-quinn-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span>, <span title=\"Codes:{http://loinc.org 73780-9}\">Congenital anomalies of the newborn [US Standard Certificate of Live Birth]</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 12770006}\">Cyanotic congenital heart disease (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
]
},
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73780-9",
"display" : "Congenital anomalies of the newborn [US Standard Certificate of Live Birth]"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "12770006",
"display" : "Cyanotic congenital heart disease (disorder)"
}
],
"text" : "Cyanotic congenital heart disease (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/condition-congenital-anomaly-of-newborn-babyg-quinn-2",
"resource" : {
"resourceType" : "Condition",
"id" : "condition-congenital-anomaly-of-newborn-babyg-quinn-2",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-congenital-anomaly-of-newborn"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Condition_condition-congenital-anomaly-of-newborn-babyg-quinn-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Condition condition-congenital-anomaly-of-newborn-babyg-quinn-2</b></p><a name=\"condition-congenital-anomaly-of-newborn-babyg-quinn-2\"> </a><a name=\"hccondition-congenital-anomaly-of-newborn-babyg-quinn-2\"> </a><a name=\"hccondition-congenital-anomaly-of-newborn-babyg-quinn-2-en-US\"> </a><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}\">Problem List Item</span>, <span title=\"Codes:{http://loinc.org 73780-9}\">Congenital anomalies of the newborn [US Standard Certificate of Live Birth]</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 70156005}\">Anomaly of chromosome pair 21 (disorder)</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">Patient - Child (Baby G Quinn)</a></p><h3>Evidences</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 312948004}\">Karyotype determination pending</span></td></tr></table></div>"
},
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
],
"text" : "Active"
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item",
"display" : "Problem List Item"
}
]
},
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73780-9",
"display" : "Congenital anomalies of the newborn [US Standard Certificate of Live Birth]"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "70156005",
"display" : "Anomaly of chromosome pair 21 (disorder)"
}
],
"text" : "Anomaly of chromosome pair 21 (disorder)"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "Patient - Child (Baby G Quinn)"
},
"evidence" : [
{
"code" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "312948004",
"display" : "Karyotype determination"
}
],
"text" : "Karyotype determination pending"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-infant-living-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-infant-living-babyg-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-infant-living-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-infant-living-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-infant-living-babyg-quinn</b></p><a name=\"observation-infant-living-babyg-quinn\"> </a><a name=\"hcobservation-infant-living-babyg-quinn\"> </a><a name=\"hcobservation-infant-living-babyg-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73757-7}\">Infant living at time of report [US Standard Certificate of Live Birth]</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</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>: true</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73757-7",
"display" : "Infant living at time of report [US Standard Certificate of Live Birth]"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-infant-breastfed-at-discharge-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-infant-breastfed-at-discharge-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-infant-breastfed-at-discharge"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-infant-breastfed-at-discharge-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-infant-breastfed-at-discharge-babyg-quinn</b></p><a name=\"observation-infant-breastfed-at-discharge-babyg-quinn\"> </a><a name=\"hcobservation-infant-breastfed-at-discharge-babyg-quinn\"> </a><a name=\"hcobservation-infant-breastfed-at-discharge-babyg-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73756-9}\">Infant is being breastfed at discharge [US Standard Certificate of Live Birth]</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</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>: true</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73756-9",
"display" : "Infant is being breastfed at discharge [US Standard Certificate of Live Birth]"
}
],
"text" : "Infant is being breastfed at discharge [US Standard Certificate of Live Birth]"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-mother-married-during-pregnancy-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-mother-married-during-pregnancy-jada-ann-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-mother-married-during-pregnancy"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-mother-married-during-pregnancy-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-mother-married-during-pregnancy-jada-ann-quinn</b></p><a name=\"observation-mother-married-during-pregnancy-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-married-during-pregnancy-jada-ann-quinn\"> </a><a name=\"hcobservation-mother-married-during-pregnancy-jada-ann-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87301-8}\">Was mother married at conception, at the time of birth, or at any time between conception and giving birth?</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}\">Yes</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87301-8",
"display" : "Mother was married at any time during pregnancy"
}
],
"text" : "Was mother married at conception, at the time of birth, or at any time between conception and giving birth?"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "Y",
"display" : "Yes"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-parent-education-level-jada-ann-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-parent-education-level-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-parent-education-level-jada-ann-quinn</b></p><a name=\"observation-parent-education-level-jada-ann-quinn\"> </a><a name=\"hcobservation-parent-education-level-jada-ann-quinn\"> </a><a name=\"hcobservation-parent-education-level-jada-ann-quinn-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-child-babyg-quinn.html\">Baby G Quinn Female, DoB: 2019-02-12 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{urn:oid:2.16.840.1.114222.4.5.274 PHC1455}\">Doctorate Degree or Professional Degree</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "57712-2",
"display" : "Highest level of education Mother"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:oid:2.16.840.1.114222.4.5.274",
"code" : "PHC1455",
"display" : "Doctorate Degree or Professional Degree"
}
],
"text" : "Doctorate Degree or Professional Degree"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-ssn-requested-for-child-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-ssn-requested-for-child-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-ssn-requested-for-child"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-ssn-requested-for-child-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-ssn-requested-for-child-babyg-quinn</b></p><a name=\"observation-ssn-requested-for-child-babyg-quinn\"> </a><a name=\"hcobservation-ssn-requested-for-child-babyg-quinn\"> </a><a name=\"hcobservation-ssn-requested-for-child-babyg-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87295-2}\">Social security number requested for child</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: true</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87295-2",
"display" : "Social Security Number was requested"
}
],
"text" : "Social security number requested for child"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/RelatedPerson/relatedperson-father-natural-james-brandon-quinn",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "relatedperson-father-natural-james-brandon-quinn",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/RelatedPerson-father-natural-vr"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_relatedperson-father-natural-james-brandon-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson relatedperson-father-natural-james-brandon-quinn</b></p><a name=\"relatedperson-father-natural-james-brandon-quinn\"> </a><a name=\"hcrelatedperson-father-natural-james-brandon-quinn\"> </a><a name=\"hcrelatedperson-father-natural-james-brandon-quinn-en-US\"> </a><p><b>identifier</b>: Social Security number/132225987</p><p><b>active</b>: true</p><p><b>patient</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">Baby G Quinn Female, DoB: 2019-02-12 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode NFTH}\">Natural Father</span></p><p><b>name</b>: James Brandon Quinn (Official)</p><p><b>gender</b>: Male</p><p><b>birthDate</b>: 1972-11-24</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" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
]
},
{
"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" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not Hispanic or Latino"
}
]
},
{
"url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-relatedperson-birthplace-vr",
"valueAddress" : {
"state" : "NY"
}
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "SS"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-ssn",
"value" : "132225987"
}
],
"active" : true,
"patient" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "NFTH",
"display" : "natural father"
}
],
"text" : "Natural Father"
}
],
"name" : [
{
"use" : "official",
"family" : "Quinn",
"given" : [
"James",
"Brandon"
]
}
],
"gender" : "male",
"birthDate" : "1972-11-24"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-paternity-acknowledgement-signed-james-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-paternity-acknowledgement-signed-james-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-paternity-acknowledgement-signed"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-paternity-acknowledgement-signed-james-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-paternity-acknowledgement-signed-james-quinn</b></p><a name=\"observation-paternity-acknowledgement-signed-james-quinn\"> </a><a name=\"hcobservation-paternity-acknowledgement-signed-james-quinn\"> </a><a name=\"hcobservation-paternity-acknowledgement-signed-james-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87302-6}\">Paternity acknowledgment form signed Father</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">Patient - Child (Baby G Quinn)</a></p><p><b>focus</b>: <a href=\"RelatedPerson-relatedperson-father-natural-james-brandon-quinn.html\">RelatedPerson - Father (James Brandon Quinn)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}\">Yes</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87302-6",
"display" : "Paternity acknowledgment form signed Father"
}
],
"text" : "Paternity acknowledgment form signed Father"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "Patient - Child (Baby G Quinn)"
},
"focus" : [
{
🔗 "reference" : "RelatedPerson/relatedperson-father-natural-james-brandon-quinn",
"display" : "RelatedPerson - Father (James Brandon Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0532",
"code" : "Y",
"display" : "Yes"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-parent-education-level-james-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-parent-education-level-james-quinn",
"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-james-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-parent-education-level-james-quinn</b></p><a name=\"observation-parent-education-level-james-quinn\"> </a><a name=\"hcobservation-parent-education-level-james-quinn\"> </a><a name=\"hcobservation-parent-education-level-james-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 87300-0}\">Highest level of education Father</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">Baby G Quinn Female, DoB: 2019-02-12 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>focus</b>: <a href=\"RelatedPerson-relatedperson-father-natural-james-brandon-quinn.html\">RelatedPerson James Brandon Quinn (official)</a></p><p><b>effective</b>: 2019-12-02</p><p><b>performer</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Jada Ann Quinn (official) Female, DoB: 1985-01-15 ( Medical Record Number: 1032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>value</b>: <span title=\"Codes:{urn:oid:2.16.840.1.114222.4.5.274 PHC1455}\">Doctorate Degree or Professional Degree</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "87300-0",
"display" : "Highest level of education Father"
}
]
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn"
},
"focus" : [
{
🔗 "reference" : "RelatedPerson/relatedperson-father-natural-james-brandon-quinn"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:oid:2.16.840.1.114222.4.5.274",
"code" : "PHC1455",
"display" : "Doctorate Degree or Professional Degree"
}
],
"text" : "Doctorate Degree or Professional Degree"
}
}
},
{
"fullUrl" : "http://example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-mothers-live-birth-jada-quinn",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "QuestionnaireResponse-mothers-live-birth-jada-quinn",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_QuestionnaireResponse-mothers-live-birth-jada-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse QuestionnaireResponse-mothers-live-birth-jada-quinn</b></p><a name=\"QuestionnaireResponse-mothers-live-birth-jada-quinn\"> </a><a name=\"hcQuestionnaireResponse-mothers-live-birth-jada-quinn\"> </a><a name=\"hcQuestionnaireResponse-mothers-live-birth-jada-quinn-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-mothers-live-birth-jada-quinn</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-mothers-live-birth.html\">Questionnaire - Mother's Worksheet for Child's Birth Certificate</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\">Jada</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\">Ann</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\">Quinn</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\"/> child-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 will be your baby's legal name (as it should appear on the birth certificate)?</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\"/> child-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\">Baby</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\"/> child-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\">G</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\"/> child-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\">Quinn</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\">1875 West Morton Avenue</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\">Salt Lake City</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_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-county</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">County</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\">Salt Lake</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-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 (or U.S. Territory, Canadian Province)</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\">UT</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-zip</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Zip Code</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\">84116</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\"/> inside-city-limits</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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><a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0532.html#v2-0532-Y\">expandedYes-NoIndicator</a> Y: Yes</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_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-mail</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 your mailing address</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_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-mail-same</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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\">false</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_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-mail-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</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\">1848 South 1300 East</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-mail-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\">Salt Lake City</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_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-mail-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\">UT</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-mail-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\">84401</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-dob</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 your date of birth?</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\">1985-01-15</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-birthplace</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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-birthplace-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</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\">UT</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-education</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 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: #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>unknown PHC1455: Doctorate Degree or Professional Degree</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_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-ethnicity</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? 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: 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-shl</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</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><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2186-5\">Race & Ethnicity - CDC</a> 2186-5: Not Hispanic or Latino</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_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-race</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 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: 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_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-race-category</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Race categories</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><a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CodeSystem-cdcrec.html#cdcrec-2106-3\">Race & Ethnicity - CDC</a> 2106-3: White</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_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-detailed-race</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Extended race codes</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-1004-1\">Race & Ethnicity - CDC</a> 1004-1: American Indian</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\"/> receive-wic</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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><a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0532.html#v2-0532-Y\">expandedYes-NoIndicator</a> Y: Yes</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_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\"/> infertility-treatment</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Did this pregnancy result from infertility treatment? (If yes, please answer 12a and 12b)</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_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\"/> drugs-ai-ii</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If yes, did this pregnancy result from fertility-enhancing drugs, artificial insemination, or intrauterine insemination?</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\">false</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\"/> art-ivf-gift</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If yes, did this pregnancy result from assisted reproductive technology (e.g., in-vitro fertilization (IVF), gamete intrafallopian transfer (GIFT))?</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_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_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\"/> mothers-height-feet</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Feet</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>5 ft<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codeft = 'ft')</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_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\"/> mothers-height-inches</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Inches</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>7 [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: 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\"/> mothers-prepregnancy-weight</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">lbs</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>145 [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: #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-smoking</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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_bck111.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-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-3-months-prior</td><td style=\"vertical-align: top; text-align : left; background-color: white; 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: 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_bck1110.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_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-3-months-prior-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_bck1100.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_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-3-months-prior-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\">1</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_bck111.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-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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_bck1110.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_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-1-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\">3</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_bck1100.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_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-1-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_bck111.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-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-2</td><td style=\"vertical-align: top; text-align : left; background-color: white; 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: 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_bck1110.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_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-2-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\">1</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_bck1100.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_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-2-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_bck101.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-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Group\" class=\"hierarchy\"/> mothers-smoking-trimester-3</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; 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: #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_bck1010.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_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: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-3-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_bck1000.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_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: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> mothers-smoking-trimester-3-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_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-prior-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">What name did you use prior to your first marriage?</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_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-prior-first-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">First</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\">Jada</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_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-prior-middle-name</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Middle</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\">Ann</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-prior-last-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Last</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\">King</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\"/> married-conception</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Were you married at the time you conceived this child, at the time of birth, or at any time between conception and giving birth? [If yes, please go to question 19; If no, please see below]</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_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\">James</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\">Brandon</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\">Quinn</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 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\">1983-09-27</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\"/> father-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 the father will have completed at the time of delivery? (Check the box that best describes his education. If he is 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 PHC1455: Doctorate Degree or Professional Degree</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-ethnicity</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is the father 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\"/> father-shl</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Is the father 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-2186-5\">Race & Ethnicity - CDC</a> 2186-5: Not 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\"/> father-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 the father's race? (Please check one or more races to indicate what he considers himself 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\"/> father-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-2106-3\">Race & Ethnicity - CDC</a> 2106-3: White</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\"/> parents-ssn</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Furnishing parent(s) Social Security Number(s) (SSNs) is required by Federal Law, 42 USC 405(c) (section 205(c) of the Social Security Act). The number(s) will be made available to the (State Social Services Agency) to assist with child support enforcement activities and to the Internal Revenue Service for the purpose of determining Earned Income Tax Credit compliance.</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-ssn</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 your Social Security Number?</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\">132-22-5986</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\"/> father-ssn</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 Social Security Number? If you are not married, and if a paternity acknowledgment has not been completed, leave this item blank.</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\">132-22-5987</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\"/> baby-ssn</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Do you want a Social Security Number issued for your baby? [If yes, please sign request below</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\">false</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\"/> informant-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If other than the mother, what is the name of the person providing information for this worksheet?</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\"/> informant-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\">Jane</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\"/> informant-last-name</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Last</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\">King</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_bck00.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-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> informant-relationship</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 your relationship to the baby's mother?</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 PHC1497: Other relative</span></span></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-mothers-live-birth",
"status" : "completed",
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"source" : {
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
},
"item" : [
{
"linkId" : "mother-current-legal-name",
"text" : "What is your current legal name?",
"item" : [
{
"linkId" : "mother-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Jada"
}
]
},
{
"linkId" : "mother-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "Ann"
}
]
},
{
"linkId" : "mother-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "Quinn"
}
]
}
]
},
{
"linkId" : "child-name",
"text" : "What will be your baby's legal name (as it should appear on the birth certificate)?",
"item" : [
{
"linkId" : "child-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Baby"
}
]
},
{
"linkId" : "child-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "G"
}
]
},
{
"linkId" : "child-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "Quinn"
}
]
}
]
},
{
"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" : "1875 West Morton Avenue"
}
]
},
{
"linkId" : "mother-city",
"text" : "City, Town, or Location",
"answer" : [
{
"valueString" : "Salt Lake City"
}
]
},
{
"linkId" : "mother-county",
"text" : "County",
"answer" : [
{
"valueString" : "Salt Lake"
}
]
},
{
"linkId" : "mother-state",
"text" : "State (or U.S. Territory, Canadian Province)",
"answer" : [
{
"valueString" : "UT"
}
]
},
{
"linkId" : "mother-zip",
"text" : "Zip Code",
"answer" : [
{
"valueString" : "84116"
}
]
}
]
},
{
"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" : "Y",
"display" : "Yes"
}
}
]
},
{
"linkId" : "mother-mail",
"text" : "What is your mailing address",
"item" : [
{
"linkId" : "mother-mail-same",
"text" : "Same as residence [Go to next question]",
"answer" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "mother-mail-nbr-street",
"text" : "Complete number and street",
"answer" : [
{
"valueString" : "1848 South 1300 East"
}
]
},
{
"linkId" : "mother-mail-city",
"text" : "City, Town, or Location",
"answer" : [
{
"valueString" : "Salt Lake City"
}
]
},
{
"linkId" : "mother-mail-state",
"text" : "State (or U.S. Territory, Canadian Province)",
"answer" : [
{
"valueString" : "UT"
}
]
},
{
"linkId" : "mother-mail-zip",
"text" : "Zip Code",
"answer" : [
{
"valueString" : "84401"
}
]
}
]
},
{
"linkId" : "mother-dob",
"text" : "What is your date of birth?",
"answer" : [
{
"valueDate" : "1985-01-15"
}
]
},
{
"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-state",
"text" : "State",
"answer" : [
{
"valueString" : "UT"
}
]
}
]
},
{
"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" : "PHC1455",
"display" : "Doctorate Degree or Professional Degree"
}
}
]
},
{
"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" : "2186-5",
"display" : "Not 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" : "2106-3",
"display" : "White"
}
}
]
},
{
"linkId" : "mother-detailed-race",
"text" : "Extended race codes",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "1004-1",
"display" : "American Indian"
}
}
]
}
]
},
{
"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" : "Y",
"display" : "Yes"
}
}
]
},
{
"linkId" : "infertility-treatment",
"text" : "Did this pregnancy result from infertility treatment? (If yes, please answer 12a and 12b)",
"answer" : [
{
"valueBoolean" : true,
"item" : [
{
"linkId" : "drugs-ai-ii",
"text" : "If yes, did this pregnancy result from fertility-enhancing drugs, artificial insemination, or intrauterine insemination?",
"answer" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "art-ivf-gift",
"text" : "If yes, did this pregnancy result from assisted reproductive technology (e.g., in-vitro fertilization (IVF), gamete intrafallopian transfer (GIFT))?",
"answer" : [
{
"valueBoolean" : true
}
]
}
]
}
]
},
{
"linkId" : "mothers-height",
"text" : "What is your height?",
"item" : [
{
"linkId" : "mothers-height-feet",
"text" : "Feet",
"answer" : [
{
"valueQuantity" : {
"value" : 5,
"unit" : "ft",
"system" : "http://unitsofmeasure.org",
"code" : "ft"
}
}
]
},
{
"linkId" : "mothers-height-inches",
"text" : "Inches",
"answer" : [
{
"valueQuantity" : {
"value" : 7,
"unit" : "[in_i]",
"system" : "http://unitsofmeasure.org",
"code" : "[in_i]"
}
}
]
}
]
},
{
"linkId" : "mothers-prepregnancy-weight",
"text" : "lbs",
"answer" : [
{
"valueQuantity" : {
"value" : 145,
"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" : 1
}
]
}
]
},
{
"linkId" : "mothers-smoking-trimester-1",
"text" : "First three months of pregnancy",
"item" : [
{
"linkId" : "mothers-smoking-trimester-1-cig",
"text" : "# of cigarettes*",
"answer" : [
{
"valueInteger" : 3
}
]
},
{
"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" : 1
}
]
},
{
"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
}
]
}
]
}
]
},
{
"linkId" : "mother-prior-name",
"text" : "What name did you use prior to your first marriage?",
"item" : [
{
"linkId" : "mother-prior-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Jada"
}
]
},
{
"linkId" : "mother-prior-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "Ann"
}
]
},
{
"linkId" : "mother-prior-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "King"
}
]
}
]
},
{
"linkId" : "married-conception",
"text" : "Were you married at the time you conceived this child, at the time of birth, or at any time between conception and giving birth? [If yes, please go to question 19; If no, please see below]",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"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" : "James"
}
]
},
{
"linkId" : "father-middle-name",
"text" : "Middle",
"answer" : [
{
"valueString" : "Brandon"
}
]
},
{
"linkId" : "father-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "Quinn"
}
]
}
]
},
{
"linkId" : "father-dob",
"text" : "What the father's date of birth?",
"answer" : [
{
"valueDate" : "1983-09-27"
}
]
},
{
"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" : "father-education",
"text" : "What is the highest level of schooling that the father will have completed at the time of delivery? (Check the box that best describes his education. If he is 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" : "PHC1455",
"display" : "Doctorate Degree or Professional Degree"
}
}
]
},
{
"linkId" : "father-ethnicity",
"text" : "Is the father Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box.",
"item" : [
{
"linkId" : "father-shl",
"text" : "Is the father Spanish/Hispanic/Latina",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2186-5",
"display" : "Not Hispanic or Latino"
}
}
]
}
]
},
{
"linkId" : "father-race",
"text" : "What is the father's race? (Please check one or more races to indicate what he considers himself to be).",
"item" : [
{
"linkId" : "father-race-category",
"text" : "Race categories",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2106-3",
"display" : "White"
}
}
]
}
]
},
{
"linkId" : "parents-ssn",
"text" : "Furnishing parent(s) Social Security Number(s) (SSNs) is required by Federal Law, 42 USC 405(c) (section 205(c) of the Social Security Act). The number(s) will be made available to the (State Social Services Agency) to assist with child support enforcement activities and to the Internal Revenue Service for the purpose of determining Earned Income Tax Credit compliance.",
"item" : [
{
"linkId" : "mother-ssn",
"text" : "What is your Social Security Number?",
"answer" : [
{
"valueString" : "132-22-5986"
}
]
},
{
"linkId" : "father-ssn",
"text" : "What is the father’s Social Security Number? If you are not married, and if a paternity acknowledgment has not been completed, leave this item blank.",
"answer" : [
{
"valueString" : "132-22-5987"
}
]
}
]
},
{
"linkId" : "baby-ssn",
"text" : "Do you want a Social Security Number issued for your baby? [If yes, please sign request below",
"answer" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "informant-name",
"text" : "If other than the mother, what is the name of the person providing information for this worksheet?",
"item" : [
{
"linkId" : "informant-first-name",
"text" : "First",
"answer" : [
{
"valueString" : "Jane"
}
]
},
{
"linkId" : "informant-last-name",
"text" : "Last",
"answer" : [
{
"valueString" : "King"
}
]
}
]
},
{
"linkId" : "informant-relationship",
"text" : "What is your relationship to the baby's mother?",
"answer" : [
{
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.114222.4.5.274",
"code" : "PHC1497",
"display" : "Other relative"
}
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Location/location-east-hospital",
"resource" : {
"resourceType" : "Location",
"id" : "location-east-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-east-hospital\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location location-east-hospital</b></p><a name=\"location-east-hospital\"> </a><a name=\"hclocation-east-hospital\"> </a><a name=\"hclocation-east-hospital-en-US\"> </a><p><b>status</b>: Active</p><p><b>name</b>: East Hospital</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p></div>"
},
"status" : "active",
"name" : "East Hospital",
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "HOSP",
"display" : "Hospital"
}
]
}
]
}
},
{
"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/Location/location-north-hospital",
"resource" : {
"resourceType" : "Location",
"id" : "location-north-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-north-hospital\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location location-north-hospital</b></p><a name=\"location-north-hospital\"> </a><a name=\"hclocation-north-hospital\"> </a><a name=\"hclocation-north-hospital-en-US\"> </a><p><b>status</b>: Active</p><p><b>name</b>: North Hospital</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p></div>"
},
"status" : "active",
"name" : "North 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/Observation/observation-labor-trial-attempted-babyg-quinn",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-labor-trial-attempted-babyg-quinn",
"meta" : {
"profile" : [
🔗 "https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-labor-trial-attempted"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_observation-labor-trial-attempted-babyg-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation observation-labor-trial-attempted-babyg-quinn</b></p><a name=\"observation-labor-trial-attempted-babyg-quinn\"> </a><a name=\"hcobservation-labor-trial-attempted-babyg-quinn\"> </a><a name=\"hcobservation-labor-trial-attempted-babyg-quinn-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 73760-1}\">If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth]</span></p><p><b>subject</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">BabyG Quinn</a></p><p><b>focus</b>: <a href=\"Patient-patient-mother-jada-ann-quinn.html\">Patient - Mother (Jada Ann Quinn)</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>: true</p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "73760-1",
"display" : "If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth]"
}
],
"text" : "If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth]"
},
"subject" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn",
"display" : "BabyG Quinn"
},
"focus" : [
{
🔗 "reference" : "Patient/patient-mother-jada-ann-quinn",
"display" : "Patient - Mother (Jada Ann Quinn)"
}
],
"effectiveDateTime" : "2019-12-02",
"performer" : [
{
🔗 "reference" : "Practitioner/practitioner-vital-records-janet-seito"
}
],
"valueBoolean" : true
}
},
{
"fullUrl" : "http://example.org/fhir/RelatedPerson/relatedperson-mother-jada-ann-quinn",
"resource" : {
"resourceType" : "RelatedPerson",
"id" : "relatedperson-mother-jada-ann-quinn",
"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-jada-ann-quinn\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson relatedperson-mother-jada-ann-quinn</b></p><a name=\"relatedperson-mother-jada-ann-quinn\"> </a><a name=\"hcrelatedperson-mother-jada-ann-quinn\"> </a><a name=\"hcrelatedperson-mother-jada-ann-quinn-en-US\"> </a><p><b>identifier</b>: Social Security number/132225986\u00a0(use:\u00a0usual,\u00a0)</p><p><b>active</b>: true</p><p><b>patient</b>: <a href=\"Patient-patient-child-babyg-quinn.html\">Baby G Quinn Female, DoB: 2019-02-12 ( Medical Record Number: 9932702\u00a0(use:\u00a0usual,\u00a0))</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>: Jada Ann Quinn (Official)</p><p><b>telecom</b>: ph: 1-(404)555-1212(Home), <a href=\"mailto:jadaann.quinn@example.com\">jadaann.quinn@example.com</a></p><p><b>gender</b>: Female</p><p><b>birthDate</b>: 1985-01-15</p><p><b>address</b>: 1875 West Morton Avenue Salt Lake City UT 84116 US (home)</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" : "2106-3",
"display" : "White"
}
},
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "1002-5",
"display" : "American Indian or Alaska Native"
}
},
{
"url" : "text",
"valueString" : "White, American Indian or Alaska Native"
}
]
},
{
"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" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not Hispanic or Latino"
}
]
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "SS",
"display" : "Social Security number"
}
]
},
"system" : "http://hl7.org/fhir/sid/us-ssn",
"value" : "132225986"
}
],
"active" : true,
"patient" : {
🔗 "reference" : "Patient/patient-child-babyg-quinn"
},
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "GESTM",
"display" : "gestational mother"
}
],
"text" : "Gestational Mother"
}
],
"name" : [
{
"use" : "official",
"family" : "Quinn",
"given" : [
"Jada",
"Ann"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "1-(404)555-1212",
"use" : "home"
},
{
"system" : "email",
"value" : "jadaann.quinn@example.com"
}
],
"gender" : "female",
"birthDate" : "1985-01-15",
"address" : [
{
"use" : "home",
"line" : [
"1875 West Morton Avenue"
],
"city" : "Salt Lake City",
"district" : "Salt Lake",
"state" : "UT",
"postalCode" : "84116",
"country" : "US"
}
]
}
}
]
}
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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