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
<Bundle xmlns="http://hl7.org/fhir">
<id value="bundle-provider-live-birth-babyg-quinn"/>
<meta>
<versionId value="4"/>
<lastUpdated value="2023-07-07T02:39:35.768Z"/>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Bundle-document-bfdr"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:18825bb1-1acb-48c4-9b45-baa612640ba5"/>
</identifier>
<type value="document"/>
<timestamp value="2019-02-11T02:05:44.434Z"/>
<entry>
<fullUrl
value="http://example.org/fhir/Composition/composition-provider-live-birth-babyg-quinn"/>
<resource>
<Composition>
<id value="composition-provider-live-birth-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Composition-provider-live-birth-report"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<extension
url="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-certificate-number">
<valueIdentifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="BCT"/>
</coding>
</type>
<value value="15075"/>
</valueIdentifier>
</extension>
<extension
url="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-live-birth-local-file-number">
<valueIdentifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="BCFN"/>
</coding>
</type>
<value value="444455555"/>
</valueIdentifier>
</extension>
<extension
url="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-date-filed-by-registrar">
<valueDateTime value="2019-02-12"/>
</extension>
<identifier>
<value value="a03eab8c-11e8-4d0c-ad2a-b385395e27de"/>
</identifier>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="68998-4"/>
<display
value="U.S. standard certificate of live birth - 2003 revision"/>
</coding>
</type>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="Patient - Child (Baby G Quinn)"/>
</subject>
<encounter>🔗
<extension
url="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Extension-encounter-maternity-reference">
<valueReference>🔗
<reference
value="Encounter/encounter-maternity-jada-ann-quinn"/>
</valueReference>
</extension>
<reference value="Encounter/encounter-birth-babyg-quinn"/>
<display value="Encounter - Birth (Baby G Quinn)"/>
</encounter>
<date value="2019-02-12"/>
<author>🔗
<reference
value="Practitioner/practitioner-vital-records-avery-jones"/>
<display
value="Practitioner - Vital Records (Dr. Avery Jones, MD)"/>
</author>
<title value="Provider supplied live birth report Document"/>
<section>
<title
value="Mother (prenatal) Section on the Live Birth Certificate"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="57073-9"/>
<display value="Prenatal records"/>
</coding>
</code>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<entry>🔗
<reference
value="Observation/observation-planned-to-deliver-at-home-babyg-quinn"/>
<display
value="Observation - Planned to Deliver at Home (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-date-of-first-prenatal-care-visit-jada-ann-quinn"/>
<display
value="Observation - Date of First Prenantal Care Visit (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-number-prenatal-visits-jada-ann-quinn"/>
<display
value="Observation - Number Prenatal Visits (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-last-menstrual-period-jada-ann-quinn"/>
<display
value="Observation - Last Menstrual Period (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-number-births-now-living-jada-ann-quinn"/>
<display
value="Observation - Number Births Now Living (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-number-births-now-dead-jada-ann-quinn"/>
<display
value="Observation - Number Births Now Dead (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-date-of-last-live-birth-jada-ann-quinn"/>
<display
value="Observation - Date of Last Live Birth (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-number-other-pregnancy-outcomes-jada-ann-quinn"/>
<display
value="Observation - Number Other Pregnancy Outcomes (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn"/>
<display
value="Observation - Date of Last Other Pregnancy Outcome (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Coverage/coverage-principal-payer-for-delivery-jada-ann-quinn"/>
<display
value="Coverage - Principal Payer for Delivery (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-mother-delivery-weight-jada-ann-quinn"/>
<display
value="Observation - Mother Delivery Weight (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-mother-height-jada-ann-quinn"/>
<display
value="Observation - Observation - Mother Height (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-mother-prepregnancy-weight-jada-ann-quinn"/>
<display
value="Observation - Mother Prepregnancy Weight (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-mother-received-wic-food-jada-ann-quinn"/>
<display
value="Observation - Mother Received WIC Food (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-cig-smoking-pregnancy-1-jada-ann-quinn"/>
<display
value="Observation - Cigarette Smoking Before/During Pregnancy (3 months prior: Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-cig-smoking-pregnancy-2-jada-ann-quinn"/>
<display
value="Observation - Cigarette Smoking Before/During Pregnancy (first 3 months: Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-cig-smoking-pregnancy-3-jada-ann-quinn"/>
<display
value="Observation - Cigarette Smoking Before/During Pregnancy (second 3 months: Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-cig-smoking-pregnancy-4-jada-ann-quinn"/>
<display
value="Observation - Cigarette Smoking Before/During Pregnancy (last 3 months: Jada Ann Quinn)"/>
</entry>
</section>
<section>
<title value="Medical Health Information Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="55752-0"/>
<display value="Clinical information"/>
</coding>
</code>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<entry>🔗
<reference
value="Condition/condition-prepregnancy-diabetes-jada-ann-quinn"/>
<display
value="Condition - Prepregnancy Diabetes - Jada Ann Quinn"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-gestational-hypertension-jada-ann-quinn"/>
<display
value="Observation - Pregnancy Risk Factor (Jada Ann Quinn: Pregnancy-induced hypertension)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-number-previous-cesareans-jada-ann-quinn"/>
<display
value="Observation - Number Previous Cesareans (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-infection-present-during-pregnancy-jada-ann-quinn"/>
<display
value="Condition - Infection Present During Pregnancy (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Procedure/procedure-obstetric-procedure-jada-ann-quinn"/>
<display
value="Procedure - Obstetric Procedure (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-chorioamnionitis-jada-ann-quinn"/>
<display
value="Condition - Characteristic of Labor and Delivery (Jada Ann Quinn: Chorioamnionitis)"/>
</entry>
<entry>🔗
<reference
value="Procedure/procedure-induction-of-labor-jada-ann-quinn"/>
<display
value="Procedure - Characteristic of Labor and Delivery (Jada Ann Quinn: Induction of Labor)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-fetal-presentation-babyg-quinn"/>
<display value="Observation - Fetal Presentation (Baby G Quinn)"/>
</entry>
<entry>🔗
<reference
value="Procedure/procedure-final-route-method-delivery-babyg-quinn"/>
<display
value="Procedure - Final Route and Method of Delivery (Baby G Quinn)"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-ruptured-uterus-jada-ann-quinn"/>
<display
value="Condition - Maternal Morbidity - Ruptured Uterus (Jada Ann Quinn)"/>
</entry>
</section>
<section>
<title value="Newborn section on the Live Birth Certificate"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="57075-4"/>
<display value="Newborn delivery information"/>
</coding>
</code>
<entry>🔗
<reference
value="Observation/observation-birth-weight-babyg-quinn"/>
<display value="Observation - Birth Weight (Baby G Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-gestational-age-at-delivery-babyg-quinn"/>
<display
value="Observation - Gestational Age at Delivery (Baby G Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-apgar-score-babyg-quinn-1-min"/>
<display value="Observation - Apgar Score (BabyG Quinn: 1 min)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-apgar-score-babyg-quinn-5-min"/>
<display value="Observation - Apgar Score (BabyG Quinn: 5 min)"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-congenital-anomaly-of-newborn-babyg-quinn"/>
<display
value="Condition - Congenital Anomaly of Newborn (BabyG Quinn) 1"/>
</entry>
<entry>🔗
<reference
value="Condition/condition-congenital-anomaly-of-newborn-babyg-quinn-2"/>
<display
value="Condition - Congenital Anomaly of Newborn (Baby G Quinn) 2"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-infant-living-babyg-quinn"/>
<display value="Observation - Infant Living (Baby G Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-infant-breastfed-at-discharge-babyg-quinn"/>
<display
value="Observation - Infant Breastfed at Discharge (Baby G Quinn)"/>
</entry>
</section>
<section>
<title value="Mother's Information Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92014-0"/>
<display value="Mother's administrative information"/>
</coding>
</code>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<entry>🔗
<reference
value="Observation/observation-mother-married-during-pregnancy-jada-ann-quinn"/>
<display
value="Observation - Mother Married During Pregnancy (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-parent-education-level-jada-ann-quinn"/>
<display
value="Observation - Parent Education Level (Jada Ann Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-ssn-requested-for-child-babyg-quinn"/>
<display
value="Observation - SSN Requested for Child (Jada Ann Quinn)"/>
</entry>
</section>
<section>
<title value="Father's Information Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92013-2"/>
<display value="Father's Administrative Information"/>
</coding>
</code>
<focus>🔗
<reference
value="RelatedPerson/relatedperson-father-natural-james-brandon-quinn"/>
<display value="RelatedPerson - Father (James Brandon Quinn)"/>
</focus>
<entry>🔗
<reference
value="Observation/observation-paternity-acknowledgement-signed-james-quinn"/>
<display
value="Observation - Paternity Acknowledgement Signed (James Brandon Quinn)"/>
</entry>
<entry>🔗
<reference
value="Observation/observation-parent-education-level-james-quinn"/>
<display
value="Observation - Parent Education Level (James Brandon Quinn)"/>
</entry>
</section>
<section>
<title value="Mother's QuestionnaireResponse Section"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="74465-6"/>
<display value="Questionnaire response Document"/>
</coding>
</code>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<entry>🔗
<reference
value="QuestionnaireResponse/QuestionnaireResponse-mothers-live-birth-jada-quinn"/>
<display
value="QuestionnaireResponse - Mother's Worksheet for Live Birth Certificate"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Patient/patient-child-babyg-quinn"/>
<resource>
<Patient>
<id value="patient-child-babyg-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-child-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</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:
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- 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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
<valueCode value="F"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/patient-birthPlace">
<valueAddress>
<city value="Salt Lake City"/>
<district value="Salt Lake"/>
<state value="UT"/>
</valueAddress>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="9932702"/>
</identifier>
<name>
<family value="Quinn"/>
<given value="Baby"/>
<given value="G"/>
</name>
<gender value="female"/>
<birthDate value="2019-02-12">
<extension
url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
<valueDateTime value="2019-02-12T13:00:00-07:00"/>
</extension>
</birthDate>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Encounter/encounter-birth-babyg-quinn"/>
<resource>
<Encounter>
<id value="encounter-birth-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Encounter-birth"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hospital.smarthealthit.org"/>
<value value="9937012"/>
</identifier>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="IMP"/>
<display value="inpatient encounter"/>
</class>
<type>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="99234"/>
</coding>
<text
value="Under Observation or Inpatient Care Services (Including Admission and Discharge Services)"/>
</type>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<participant>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="87287-9"/>
<display value="Birth certifier [Extended Identifier]"/>
</coding>
</type>
<period>
<start value="2019-02-12T13:30:00-07:00"/>
</period>
<individual>🔗
<reference
value="Practitioner/practitioner-vital-records-avery-jones"/>
<display value="Practitioner - Vital Records (Avery Jones, MD)"/>
</individual>
</participant>
<participant>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="87286-1"/>
<display value="Birth attendant [Extended Identifier]"/>
</coding>
</type>
<individual>🔗
<reference
value="Practitioner/practitioner-vital-records-avery-jones"/>
<display value="Practitioner - Vital Records (Avery Jones, MD)"/>
</individual>
</participant>
<period>
<start value="2019-02-12T13:00:00-07:00"/>
<end value="2019-02-15T10:00:00-07:00"/>
</period>
<hospitalization>
<destination>🔗
<reference value="Location/location-east-hospital"/>
<display value="East Hospital Location"/>
</destination>
<dischargeDisposition>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/discharge-disposition"/>
<code value="other-hcf"/>
<display value="Other healthcare facility"/>
</coding>
<text
value="The patient was transferred to another healthcare facility."/>
</dischargeDisposition>
</hospitalization>
<location>
<location>🔗
<reference value="Location/location-south-hospital"/>
<display value="Location - US Core Location (South Hospital)"/>
</location>
<physicalType>
<coding>
<system value="http://snomed.info/sct"/>
<code value="22232009"/>
<display value="Hospital"/>
</coding>
</physicalType>
</location>
<partOf>🔗
<reference value="Encounter/encounter-maternity-jada-ann-quinn"/>
<display value="Maternity Encounter - Jada Ann Quinn"/>
</partOf>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Encounter/encounter-maternity-jada-ann-quinn"/>
<resource>
<Encounter>
<id value="encounter-maternity-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Encounter-maternity"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hospital.smarthealthit.org"/>
<value value="9937012"/>
</identifier>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="IMP"/>
<display value="inpatient encounter"/>
</class>
<type>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="99234"/>
</coding>
<text
value="Under Observation or Inpatient Care Services (Including Admission and Discharge Services)"/>
</type>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<participant>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="87286-1"/>
<display value="Birth attendant [Extended Identifier]"/>
</coding>
</type>
<individual>🔗
<reference
value="Practitioner/practitioner-vital-records-avery-jones"/>
<display value="Practitioner - Vital Records (Avery Jones, MD)"/>
</individual>
</participant>
<period>
<start value="2019-02-11T10:00:00-07:00"/>
<end value="2019-02-15T10:00:00-07:00"/>
</period>
<hospitalization>
<origin>🔗
<reference value="Location/location-north-hospital"/>
<display value="Location - US Core Location (North Hospital)"/>
</origin>
<admitSource>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/admit-source"/>
<code value="hosp-trans"/>
<display value="Transferred from other hospital"/>
</coding>
<text
value="The Patient has been transferred from another hospital for this encounter."/>
</admitSource>
</hospitalization>
<location>
<location>🔗
<reference value="Location/location-south-hospital"/>
<display value="Location - US Core Location (South Hospital)"/>
</location>
<physicalType>
<coding>
<system value="http://snomed.info/sct"/>
<code value="22232009"/>
<display value="Hospital"/>
</coding>
</physicalType>
</location>
<serviceProvider>🔗
<reference value="Organization/organization-south-hospital"/>
<display
value="Organization - US Core Organization (South Hospital Organization)"/>
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Practitioner/practitioner-vital-records-avery-jones"/>
<resource>
<Practitioner>
<id value="practitioner-vital-records-avery-jones"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Practitioner-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="112247003"/>
</identifier>
<name>
<family value="Jones"/>
<given value="Avery"/>
<suffix value="M.D."/>
</name>
<!-- Using the osteo code until PhinVads updates the value set with an active code for Medical Doctor -->
<qualification>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="76231001"/>
<display value="Osteopath (occupation)"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Patient/patient-mother-jada-ann-quinn"/>
<resource>
<Patient>
<id value="patient-mother-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</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 (use: usual, )</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:
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- 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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="1002-5"/>
<display value="American Indian or Alaska Native"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White, American Indian or Alaska Native"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
<valueCode value="F"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/patient-birthPlace">
<valueAddress>
<state value="UT"/>
</valueAddress>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SS"/>
<display value="Social Security number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="132225986"/>
</identifier>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="1032702"/>
</identifier>
<name>
<use value="official"/>
<family value="Quinn"/>
<given value="Jada"/>
<given value="Ann"/>
</name>
<name>
<use value="maiden"/>
<family value="King"/>
<given value="Jada"/>
<given value="Ann"/>
</name>
<telecom>
<system value="phone"/>
<value value="1-(404)555-1212"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="jadaann.quinn@example.com"/>
</telecom>
<gender value="female"/>
<birthDate value="1985-01-15"/>
<address>
<extension
url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator-vr">
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</valueCoding>
</extension>
<use value="home"/>
<line value="1875 West Morton Avenue"/>
<city value="Salt Lake City"/>
<district value="Salt Lake"/>
<state value="UT"/>
<postalCode value="84116"/>
<country value="US"/>
</address>
<address>
<use value="billing"/>
<line value="1848 South 1300 East"/>
<city value="Salt Lake City"/>
<state value="UT"/>
<postalCode value="84401"/>
<country value="US"/>
</address>
<link>
<other>🔗
<reference
value="RelatedPerson/relatedperson-mother-jada-ann-quinn"/>
</other>
<type value="seealso"/>
</link>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-planned-to-deliver-at-home-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-planned-to-deliver-at-home-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-planned-to-deliver-at-home"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: true</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="73765-0"/>
<display
value="Mother Planned to deliver at home [US Standard Certificate of Live Birth]"/>
</coding>
<text value="Planned to deliver at home?"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueBoolean value="true"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-jada-ann-quinn"/>
<resource>
<Observation>
<id
value="observation-date-of-first-prenatal-care-visit-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-first-prenatal-care-visit"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69044-6"/>
<display value="Date first prenatal visit"/>
</coding>
<text value="Date of first prenatal care visit"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueDateTime value="2018-07-20"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-number-prenatal-visits-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-number-prenatal-visits-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-prenatal-visits-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="68493-6"/>
<display value="Prenatal visits for this pregnancy #"/>
</coding>
<text value="Prenatal visits for this pregnancy #"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="8"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-last-menstrual-period-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-last-menstrual-period-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-last-menstrual-period-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8665-2"/>
<display value="Last menstrual period start date"/>
</coding>
<text value="Last menstrual period start date"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueDateTime value="2018-06-05"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-number-births-now-living-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-number-births-now-living-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-living-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11638-4"/>
<display value="[#] Births.still living"/>
</coding>
<text value="[#] Births.still living"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="1"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-number-births-now-dead-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-number-births-now-dead-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-dead-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="68496-9"/>
<display value="Previous live births now dead #"/>
</coding>
<text value="Previous live births now dead #"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="0"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-date-of-last-live-birth-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-date-of-last-live-birth-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-last-live-birth"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="68499-3"/>
<display value="Date last live birth"/>
</coding>
<text value="Date of last live birth"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueDateTime value="2014-11-20"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-number-other-pregnancy-outcomes-jada-ann-quinn"/>
<resource>
<Observation>
<id
value="observation-number-other-pregnancy-outcomes-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-other-pregnancy-outcomes-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69043-8"/>
<display value="Other pregnancy outcomes #"/>
</coding>
<text value="Other pregnancy outcomes #"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="0"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn"/>
<resource>
<Observation>
<id
value="observation-date-of-last-other-pregnancy-outcome-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-date-of-last-other-pregnancy-outcome"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="68500-8"/>
<display value="Date last other pregnancy outcome"/>
</coding>
<text value="Date of last other pregnancy outcome"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueDateTime value="2015-05"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Coverage/coverage-principal-payer-for-delivery-jada-ann-quinn"/>
<resource>
<Coverage>
<id value="coverage-principal-payer-for-delivery-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Coverage-principal-payer-for-delivery"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<type>
<coding>
<system value="https://nahdo.org/sopt"/>
<code value="5"/>
<display value="PRIVATE HEALTH INSURANCE"/>
</coding>
<text value="Private Health Insurance"/>
</type>
<beneficiary>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</beneficiary>
<payor>
<extension
url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode value="not-asked"/>
</extension>
<display value="Not asked"/>
</payor>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-mother-delivery-weight-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-mother-delivery-weight-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-delivery-weight-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69461-2"/>
<display value="Mother's body weight --at delivery"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-02-12"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueQuantity>
<value value="175"/>
<system value="http://unitsofmeasure.org"/>
<code value="[lb_av]"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-mother-height-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-mother-height-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-height-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="3137-7"/>
<display value="Body height Measured"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-02-10"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueQuantity>
<value value="67"/>
<system value="http://unitsofmeasure.org"/>
<code value="[in_i]"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-mother-prepregnancy-weight-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-mother-prepregnancy-weight-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-prepregnancy-weight-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="56077-1"/>
<display value="Body weight --pre current pregnancy"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-06-20"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueQuantity>
<value value="145"/>
<system value="http://unitsofmeasure.org"/>
<code value="[lb_av]"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-mother-received-wic-food-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-mother-received-wic-food-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-mother-received-wic-food"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}">Yes</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87303-4"/>
<display value="Mother WIC food recipient"/>
</coding>
<text
value="Did mother get WIC food for herself during this pregnancy?"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-cig-smoking-pregnancy-1-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: 20</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="64794-1"/>
<display
value="In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]"/>
</coding>
<text
value="In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<focus>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueInteger value="20"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-cig-smoking-pregnancy-2-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: 3</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87298-6"/>
<display
value="Cigarettes smoked per day by Mother--1st trimester"/>
</coding>
<text value="Cigarettes smoked per day by Mother--1st trimester"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<focus>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueInteger value="3"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-cig-smoking-pregnancy-3-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: 1</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87299-4"/>
<display
value="Cigarettes smoked per day by Mother--2nd trimester"/>
</coding>
<text value="Cigarettes smoked per day by Mother--2nd trimester"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<focus>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueInteger value="1"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-cig-smoking-pregnancy-4-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: 0</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="64795-8"/>
<display
value="In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]"/>
</coding>
<text
value="In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<focus>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueInteger value="0"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-prepregnancy-diabetes-jada-ann-quinn"/>
<resource>
<Condition>
<id value="condition-prepregnancy-diabetes-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-prepregnancy-diabetes-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="73211009"/>
<display value="Diabetes mellitus (disorder)"/>
</coding>
<text value="Diabetes mellitus (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<onsetDateTime value="2015-02-12"/>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-gestational-hypertension-jada-ann-quinn"/>
<resource>
<Condition>
<id value="condition-gestational-hypertension-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-gestational-hypertension-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="48194001"/>
<display value="Pregnancy-induced hypertension (disorder)"/>
</coding>
<text value="Pregnancy-induced hypertension (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-number-previous-cesareans-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-number-previous-cesareans-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-previous-cesareans-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="68497-7"/>
<display value="Previous cesarean deliveries #"/>
</coding>
<text value="Previous cesarean deliveries #"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="1"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-infection-present-during-pregnancy-jada-ann-quinn"/>
<resource>
<Condition>
<id
value="condition-infection-present-during-pregnancy-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-infection-present-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
</category>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="72519-2"/>
<display
value="Infections present AndOr treated during this pregnancy for live birth [US Standard Certificate of Live Birth]"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="105629000"/>
<display value="Chlamydial infection (disorder)"/>
</coding>
<text value="Chlamydial infection (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/procedure-obstetric-procedure-jada-ann-quinn"/>
<resource>
<Procedure>
<id value="procedure-obstetric-procedure-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-obstetric"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="240278000"/>
<display value="External cephalic version (procedure)"/>
</coding>
<text value="External cephalic version: Failed"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<performedPeriod>
<start value="2019-02-07T08:30:00-07:00"/>
<end value="2019-02-07T08:45:00-07:00"/>
</performedPeriod>
<outcome>
<coding>
<system value="http://snomed.info/sct"/>
<code value="385671000"/>
<display value="Unsuccessful"/>
</coding>
<text value="External cephalic version: Unsuccessful"/>
</outcome>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-chorioamnionitis-jada-ann-quinn"/>
<resource>
<Condition>
<id value="condition-chorioamnionitis-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-chorioamnionitis"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="11612004"/>
<display value="Chorioamnionitis (disorder)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/procedure-induction-of-labor-jada-ann-quinn"/>
<resource>
<Procedure>
<id value="procedure-induction-of-labor-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-induction-of-labor"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="236958009"/>
<display value="Induction of labor (procedure)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<performedPeriod>
<start value="2019-02-07T08:30:00-07:00"/>
<end value="2019-02-07T08:45:00-07:00"/>
</performedPeriod>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-fetal-presentation-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-fetal-presentation-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-fetal-presentation"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="73761-9"/>
<display
value="Fetal presentation--at birth [US Standard Certificate of Live Birth]"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="Patient - Child (Baby G Quinn)"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="6096002"/>
<display value="Breech presentation (finding)"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/procedure-final-route-method-delivery-babyg-quinn"/>
<resource>
<Procedure>
<id value="procedure-final-route-method-delivery-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Procedure-final-route-method-delivery"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="11466000"/>
<display value="Cesarean section"/>
</coding>
<text value="Cesarean section"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
<performedPeriod>
<start value="2019-02-12T12:45:00-07:00"/>
<end value="2019-02-12T13:15:00-07:00"/>
</performedPeriod>
<reasonReference>🔗
<reference
value="Observation/observation-labor-trial-attempted-babyg-quinn"/>
<display value="Labor trial attempted - true"/>
</reasonReference>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-ruptured-uterus-jada-ann-quinn"/>
<resource>
<Condition>
<id value="condition-ruptured-uterus-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-ruptured-uterus"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="34430009"/>
<display value="Rupture of uterus (disorder)"/>
</coding>
<text value="Rupture of uterus (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-birth-weight-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-birth-weight-babyg-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-birth-weight-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
<display value="Vital Signs"/>
</coding>
<text value="Vital Signs"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="8339-4"/>
<display value="Birth weight Measured"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-02-10"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueQuantity>
<value value="2500"/>
<system value="http://unitsofmeasure.org"/>
<code value="g"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-gestational-age-at-delivery-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-gestational-age-at-delivery-babyg-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-gestational-age-at-delivery-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11884-4"/>
<display value="Gestational age Estimated"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueQuantity>
<value value="36"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-apgar-score-babyg-quinn-1-min"/>
<resource>
<Observation>
<id value="observation-apgar-score-babyg-quinn-1-min"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-apgar-score-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="survey"/>
<display value="Survey"/>
</coding>
<text value="Survey"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="9272-6"/>
<display value="1 minute Apgar Score"/>
</coding>
<text value="1 minute Apgar Score"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="5"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-apgar-score-babyg-quinn-5-min"/>
<resource>
<Observation>
<id value="observation-apgar-score-babyg-quinn-5-min"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-apgar-score-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="survey"/>
<display value="Survey"/>
</coding>
<text value="Survey"/>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="9274-2"/>
<display value="5 minute Apgar Score"/>
</coding>
<text value="5 minute Apgar Score"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueInteger value="7"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-congenital-anomaly-of-newborn-babyg-quinn"/>
<resource>
<Condition>
<id value="condition-congenital-anomaly-of-newborn-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-congenital-anomaly-of-newborn"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
</category>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="73780-9"/>
<display
value="Congenital anomalies of the newborn [US Standard Certificate of Live Birth]"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="12770006"/>
<display value="Cyanotic congenital heart disease (disorder)"/>
</coding>
<text value="Cyanotic congenital heart disease (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/condition-congenital-anomaly-of-newborn-babyg-quinn-2"/>
<resource>
<Condition>
<id value="condition-congenital-anomaly-of-newborn-babyg-quinn-2"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Condition-congenital-anomaly-of-newborn"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
<display value="Active"/>
</coding>
<text value="Active"/>
</clinicalStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
<display value="Problem List Item"/>
</coding>
</category>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="73780-9"/>
<display
value="Congenital anomalies of the newborn [US Standard Certificate of Live Birth]"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="70156005"/>
<display value="Anomaly of chromosome pair 21 (disorder)"/>
</coding>
<text value="Anomaly of chromosome pair 21 (disorder)"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="Patient - Child (Baby G Quinn)"/>
</subject>
<evidence>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="312948004"/>
<display value="Karyotype determination"/>
</coding>
<text value="Karyotype determination pending"/>
</code>
</evidence>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-infant-living-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-infant-living-babyg-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-infant-living-vr"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="73757-7"/>
<display
value="Infant living at time of report [US Standard Certificate of Live Birth]"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueBoolean value="true"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-infant-breastfed-at-discharge-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-infant-breastfed-at-discharge-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-infant-breastfed-at-discharge"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="73756-9"/>
<display
value="Infant is being breastfed at discharge [US Standard Certificate of Live Birth]"/>
</coding>
<text
value="Infant is being breastfed at discharge [US Standard Certificate of Live Birth]"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueBoolean value="true"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-mother-married-during-pregnancy-jada-ann-quinn"/>
<resource>
<Observation>
<id
value="observation-mother-married-during-pregnancy-jada-ann-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-mother-married-during-pregnancy"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}">Yes</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87301-8"/>
<display value="Mother was married at any time during pregnancy"/>
</coding>
<text
value="Was mother married at conception, at the time of birth, or at any time between conception and giving birth?"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-parent-education-level-jada-ann-quinn"/>
<resource>
<Observation>
<id value="observation-parent-education-level-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-parent-education-level-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</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 (use: usual, ))</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 (use: usual, ))</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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="57712-2"/>
<display value="Highest level of education Mother"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="urn:oid:2.16.840.1.114222.4.5.274"/>
<code value="PHC1455"/>
<display value="Doctorate Degree or Professional Degree"/>
</coding>
<text value="Doctorate Degree or Professional Degree"/>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-ssn-requested-for-child-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-ssn-requested-for-child-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-ssn-requested-for-child"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: true</p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87295-2"/>
<display value="Social Security Number was requested"/>
</coding>
<text value="Social security number requested for child"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueBoolean value="true"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/RelatedPerson/relatedperson-father-natural-james-brandon-quinn"/>
<resource>
<RelatedPerson>
<id value="relatedperson-father-natural-james-brandon-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/RelatedPerson-father-natural-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-relatedperson-birthplace-vr">
<valueAddress>
<state value="NY"/>
</valueAddress>
</extension>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SS"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="132225987"/>
</identifier>
<active value="true"/>
<patient>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="NFTH"/>
<display value="natural father"/>
</coding>
<text value="Natural Father"/>
</relationship>
<name>
<use value="official"/>
<family value="Quinn"/>
<given value="James"/>
<given value="Brandon"/>
</name>
<gender value="male"/>
<birthDate value="1972-11-24"/>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-paternity-acknowledgement-signed-james-quinn"/>
<resource>
<Observation>
<id value="observation-paternity-acknowledgement-signed-james-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-paternity-acknowledgement-signed"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</a></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0532 Y}">Yes</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87302-6"/>
<display value="Paternity acknowledgment form signed Father"/>
</coding>
<text value="Paternity acknowledgment form signed Father"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="Patient - Child (Baby G Quinn)"/>
</subject>
<focus>🔗
<reference
value="RelatedPerson/relatedperson-father-natural-james-brandon-quinn"/>
<display value="RelatedPerson - Father (James Brandon Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-parent-education-level-james-quinn"/>
<resource>
<Observation>
<id value="observation-parent-education-level-james-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-parent-education-level-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, ))</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 (use: usual, ))</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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="87300-0"/>
<display value="Highest level of education Father"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
</subject>
<focus>🔗
<reference
value="RelatedPerson/relatedperson-father-natural-james-brandon-quinn"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="urn:oid:2.16.840.1.114222.4.5.274"/>
<code value="PHC1455"/>
<display value="Doctorate Degree or Professional Degree"/>
</coding>
<text value="Doctorate Degree or Professional Degree"/>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-mothers-live-birth-jada-quinn"/>
<resource>
<QuestionnaireResponse>
<id value="QuestionnaireResponse-mothers-live-birth-jada-quinn"/>
<text>
<status value="generated"/>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
<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>
</text>
<questionnaire
value="https://profiles.ihe.net/QRPH/bfdr/Questionnaire/Questionnaire-mothers-live-birth"/>
<status value="completed"/>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<source>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</source>
<item>
<linkId value="mother-current-legal-name"/>
<text value="What is your current legal name?"/>
<item>
<linkId value="mother-first-name"/>
<text value="First"/>
<answer>
<valueString value="Jada"/>
</answer>
</item>
<item>
<linkId value="mother-middle-name"/>
<text value="Middle"/>
<answer>
<valueString value="Ann"/>
</answer>
</item>
<item>
<linkId value="mother-last-name"/>
<text value="Last"/>
<answer>
<valueString value="Quinn"/>
</answer>
</item>
</item>
<item>
<linkId value="child-name"/>
<text
value="What will be your baby's legal name (as it should appear on the birth certificate)?"/>
<item>
<linkId value="child-first-name"/>
<text value="First"/>
<answer>
<valueString value="Baby"/>
</answer>
</item>
<item>
<linkId value="child-middle-name"/>
<text value="Middle"/>
<answer>
<valueString value="G"/>
</answer>
</item>
<item>
<linkId value="child-last-name"/>
<text value="Last"/>
<answer>
<valueString value="Quinn"/>
</answer>
</item>
</item>
<item>
<linkId value="mother-address"/>
<text
value="Where do you usually live - that is - where is your household/residence located?"/>
<item>
<linkId value="mother-nbr-street"/>
<text
value="Complete number and street (do not enter rural route numbers)"/>
<answer>
<valueString value="1875 West Morton Avenue"/>
</answer>
</item>
<item>
<linkId value="mother-city"/>
<text value="City, Town, or Location"/>
<answer>
<valueString value="Salt Lake City"/>
</answer>
</item>
<item>
<linkId value="mother-county"/>
<text value="County"/>
<answer>
<valueString value="Salt Lake"/>
</answer>
</item>
<item>
<linkId value="mother-state"/>
<text value="State (or U.S. Territory, Canadian Province)"/>
<answer>
<valueString value="UT"/>
</answer>
</item>
<item>
<linkId value="mother-zip"/>
<text value="Zip Code"/>
<answer>
<valueString value="84116"/>
</answer>
</item>
</item>
<item>
<linkId value="inside-city-limits"/>
<text
value="Is this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?"/>
<answer>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="mother-mail"/>
<text value="What is your mailing address"/>
<item>
<linkId value="mother-mail-same"/>
<text value="Same as residence [Go to next question]"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="mother-mail-nbr-street"/>
<text value="Complete number and street"/>
<answer>
<valueString value="1848 South 1300 East"/>
</answer>
</item>
<item>
<linkId value="mother-mail-city"/>
<text value="City, Town, or Location"/>
<answer>
<valueString value="Salt Lake City"/>
</answer>
</item>
<item>
<linkId value="mother-mail-state"/>
<text value="State (or U.S. Territory, Canadian Province)"/>
<answer>
<valueString value="UT"/>
</answer>
</item>
<item>
<linkId value="mother-mail-zip"/>
<text value="Zip Code"/>
<answer>
<valueString value="84401"/>
</answer>
</item>
</item>
<item>
<linkId value="mother-dob"/>
<text value="What is your date of birth?"/>
<answer>
<valueDate value="1985-01-15"/>
</answer>
</item>
<item>
<linkId value="mother-birthplace"/>
<text
value="In what State, U.S. territory, or foreign country were you born? Please specify one of the following:"/>
<item>
<linkId value="mother-birthplace-state"/>
<text value="State"/>
<answer>
<valueString value="UT"/>
</answer>
</item>
</item>
<item>
<linkId value="mother-education"/>
<text
value="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 value="urn:oid:2.16.840.1.114222.4.5.274"/>
<code value="PHC1455"/>
<display value="Doctorate Degree or Professional Degree"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="mother-ethnicity"/>
<text
value="Are you Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box."/>
<item>
<linkId value="mother-shl"/>
<text value="Are you Spanish/Hispanic/Latina"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="mother-race"/>
<text
value="What is your race? (Please check one or more races to indicate what you consider yourself to be)."/>
<item>
<linkId value="mother-race-category"/>
<text value="Race categories"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="mother-detailed-race"/>
<text value="Extended race codes"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="1004-1"/>
<display value="American Indian"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="receive-wic"/>
<text
value="Did you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?"/>
<answer>
<valueCoding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0532"/>
<code value="Y"/>
<display value="Yes"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="infertility-treatment"/>
<text
value="Did this pregnancy result from infertility treatment? (If yes, please answer 12a and 12b)"/>
<answer>
<valueBoolean value="true"/>
<item>
<linkId value="drugs-ai-ii"/>
<text
value="If yes, did this pregnancy result from fertility-enhancing drugs, artificial insemination, or intrauterine insemination?"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="art-ivf-gift"/>
<text
value="If yes, did this pregnancy result from assisted reproductive technology (e.g., in-vitro fertilization (IVF), gamete intrafallopian transfer (GIFT))?"/>
<answer>
<valueBoolean value="true"/>
</answer>
</item>
</answer>
</item>
<item>
<linkId value="mothers-height"/>
<text value="What is your height?"/>
<item>
<linkId value="mothers-height-feet"/>
<text value="Feet"/>
<answer>
<valueQuantity>
<value value="5"/>
<unit value="ft"/>
<system value="http://unitsofmeasure.org"/>
<code value="ft"/>
</valueQuantity>
</answer>
</item>
<item>
<linkId value="mothers-height-inches"/>
<text value="Inches"/>
<answer>
<valueQuantity>
<value value="7"/>
<unit value="[in_i]"/>
<system value="http://unitsofmeasure.org"/>
<code value="[in_i]"/>
</valueQuantity>
</answer>
</item>
</item>
<item>
<linkId value="mothers-prepregnancy-weight"/>
<text value="lbs"/>
<answer>
<valueQuantity>
<value value="145"/>
<unit value="[lb_av]"/>
<system value="http://unitsofmeasure.org"/>
<code value="[lb_av]"/>
</valueQuantity>
</answer>
</item>
<item>
<linkId value="mothers-smoking"/>
<text
value="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 value="mothers-smoking-3-months-prior"/>
<text value="Three months before pregnancy"/>
<item>
<linkId value="mothers-smoking-3-months-prior-cig"/>
<text value="# of cigarettes*"/>
<answer>
<valueInteger value="0"/>
</answer>
</item>
<item>
<linkId value="mothers-smoking-3-months-prior-pck"/>
<text value="# of packs"/>
<answer>
<valueInteger value="1"/>
</answer>
</item>
</item>
<item>
<linkId value="mothers-smoking-trimester-1"/>
<text value="First three months of pregnancy"/>
<item>
<linkId value="mothers-smoking-trimester-1-cig"/>
<text value="# of cigarettes*"/>
<answer>
<valueInteger value="3"/>
</answer>
</item>
<item>
<linkId value="mothers-smoking-trimester-1-pck"/>
<text value="# of packs"/>
<answer>
<valueInteger value="0"/>
</answer>
</item>
</item>
<item>
<linkId value="mothers-smoking-trimester-2"/>
<text value="Second three months of pregnancy"/>
<item>
<linkId value="mothers-smoking-trimester-2-cig"/>
<text value="# of cigarettes*"/>
<answer>
<valueInteger value="1"/>
</answer>
</item>
<item>
<linkId value="mothers-smoking-trimester-2-pck"/>
<text value="# of packs"/>
<answer>
<valueInteger value="0"/>
</answer>
</item>
</item>
<item>
<linkId value="mothers-smoking-trimester-3"/>
<text value="Third trimester of pregnancy"/>
<item>
<linkId value="mothers-smoking-trimester-3-cig"/>
<text value="# of cigarettes*"/>
<answer>
<valueInteger value="0"/>
</answer>
</item>
<item>
<linkId value="mothers-smoking-trimester-3-pck"/>
<text value="# of packs"/>
<answer>
<valueInteger value="0"/>
</answer>
</item>
</item>
</item>
<item>
<linkId value="mother-prior-name"/>
<text value="What name did you use prior to your first marriage?"/>
<item>
<linkId value="mother-prior-first-name"/>
<text value="First"/>
<answer>
<valueString value="Jada"/>
</answer>
</item>
<item>
<linkId value="mother-prior-middle-name"/>
<text value="Middle"/>
<answer>
<valueString value="Ann"/>
</answer>
</item>
<item>
<linkId value="mother-prior-last-name"/>
<text value="Last"/>
<answer>
<valueString value="King"/>
</answer>
</item>
</item>
<item>
<linkId value="married-conception"/>
<text
value="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 value="true"/>
</answer>
</item>
<item>
<linkId value="father-current-legal-name"/>
<text
value="What is the current legal name of your baby's father?"/>
<item>
<linkId value="father-first-name"/>
<text value="First"/>
<answer>
<valueString value="James"/>
</answer>
</item>
<item>
<linkId value="father-middle-name"/>
<text value="Middle"/>
<answer>
<valueString value="Brandon"/>
</answer>
</item>
<item>
<linkId value="father-last-name"/>
<text value="Last"/>
<answer>
<valueString value="Quinn"/>
</answer>
</item>
</item>
<item>
<linkId value="father-dob"/>
<text value="What the father's date of birth?"/>
<answer>
<valueDate value="1983-09-27"/>
</answer>
</item>
<item>
<linkId value="father-birthplace"/>
<text
value="In what State, U.S. territory, or foreign country was the father born? Please specify one of the following:"/>
<item>
<linkId value="father-birthplace-state"/>
<text value="State"/>
<answer>
<valueString value="NY"/>
</answer>
</item>
</item>
<item>
<linkId value="father-education"/>
<text
value="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 value="urn:oid:2.16.840.1.114222.4.5.274"/>
<code value="PHC1455"/>
<display value="Doctorate Degree or Professional Degree"/>
</valueCoding>
</answer>
</item>
<item>
<linkId value="father-ethnicity"/>
<text
value="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 value="father-shl"/>
<text value="Is the father Spanish/Hispanic/Latina"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="father-race"/>
<text
value="What is the father's race? (Please check one or more races to indicate what he considers himself to be)."/>
<item>
<linkId value="father-race-category"/>
<text value="Race categories"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</answer>
</item>
</item>
<item>
<linkId value="parents-ssn"/>
<text
value="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 value="mother-ssn"/>
<text value="What is your Social Security Number?"/>
<answer>
<valueString value="132-22-5986"/>
</answer>
</item>
<item>
<linkId value="father-ssn"/>
<text
value="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 value="132-22-5987"/>
</answer>
</item>
</item>
<item>
<linkId value="baby-ssn"/>
<text
value="Do you want a Social Security Number issued for your baby? [If yes, please sign request below"/>
<answer>
<valueBoolean value="false"/>
</answer>
</item>
<item>
<linkId value="informant-name"/>
<text
value="If other than the mother, what is the name of the person providing information for this worksheet?"/>
<item>
<linkId value="informant-first-name"/>
<text value="First"/>
<answer>
<valueString value="Jane"/>
</answer>
</item>
<item>
<linkId value="informant-last-name"/>
<text value="Last"/>
<answer>
<valueString value="King"/>
</answer>
</item>
</item>
<item>
<linkId value="informant-relationship"/>
<text value="What is your relationship to the baby's mother?"/>
<answer>
<valueCoding>
<system value="urn:oid:2.16.840.1.114222.4.5.274"/>
<code value="PHC1497"/>
<display value="Other relative"/>
</valueCoding>
</answer>
</item>
</QuestionnaireResponse>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Location/location-east-hospital"/>
<resource>
<Location>
<id value="location-east-hospital"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<name value="East Hospital"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="HOSP"/>
<display value="Hospital"/>
</coding>
</type>
</Location>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Location/location-south-hospital"/>
<resource>
<Location>
<id value="location-south-hospital"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<name value="South Hospital"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="HOSP"/>
<display value="Hospital"/>
</coding>
</type>
</Location>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Location/location-north-hospital"/>
<resource>
<Location>
<id value="location-north-hospital"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<name value="North Hospital"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="HOSP"/>
<display value="Hospital"/>
</coding>
</type>
</Location>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Organization/organization-south-hospital"/>
<resource>
<Organization>
<id value="organization-south-hospital"/>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="5555512"/>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="HOSP"/>
<display value="Hospital"/>
</coding>
</type>
<name value="South Hospital"/>
<telecom>
<system value="phone"/>
<value value="+1-555-555-1111"/>
</telecom>
<telecom>
<system value="email"/>
<value value="mail@southhospital.com"/>
</telecom>
<address>
<line value="2100 North Ave"/>
<city value="Salt Lake City"/>
<state value="UT"/>
<postalCode value="84116"/>
<country value="US"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-labor-trial-attempted-babyg-quinn"/>
<resource>
<Observation>
<id value="observation-labor-trial-attempted-babyg-quinn"/>
<meta>
<profile
value="https://profiles.ihe.net/QRPH/bfdr/StructureDefinition/Observation-labor-trial-attempted"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="73760-1"/>
<display
value="If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth]"/>
</coding>
<text
value="If cesarean, a trial of labor was attempted [US Standard Certificate of Live Birth]"/>
</code>
<subject>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
<display value="BabyG Quinn"/>
</subject>
<focus>🔗
<reference value="Patient/patient-mother-jada-ann-quinn"/>
<display value="Patient - Mother (Jada Ann Quinn)"/>
</focus>
<effectiveDateTime value="2019-12-02"/>
<performer>🔗
<reference
value="Practitioner/practitioner-vital-records-janet-seito"/>
</performer>
<valueBoolean value="true"/>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/RelatedPerson/relatedperson-mother-jada-ann-quinn"/>
<resource>
<RelatedPerson>
<id value="relatedperson-mother-jada-ann-quinn"/>
<meta>
<profile
value="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/RelatedPerson-mother-gestational-vr"/>
</meta>
<text>
<status value="generated"/>
<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 (use: usual, )</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 (use: usual, ))</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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="1002-5"/>
<display value="American Indian or Alaska Native"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White, American Indian or Alaska Native"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SS"/>
<display value="Social Security number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="132225986"/>
</identifier>
<active value="true"/>
<patient>🔗
<reference value="Patient/patient-child-babyg-quinn"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="GESTM"/>
<display value="gestational mother"/>
</coding>
<text value="Gestational Mother"/>
</relationship>
<name>
<use value="official"/>
<family value="Quinn"/>
<given value="Jada"/>
<given value="Ann"/>
</name>
<telecom>
<system value="phone"/>
<value value="1-(404)555-1212"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="jadaann.quinn@example.com"/>
</telecom>
<gender value="female"/>
<birthDate value="1985-01-15"/>
<address>
<use value="home"/>
<line value="1875 West Morton Avenue"/>
<city value="Salt Lake City"/>
<district value="Salt Lake"/>
<state value="UT"/>
<postalCode value="84116"/>
<country value="US"/>
</address>
</RelatedPerson>
</resource>
</entry>
</Bundle>
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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