Generated Narrative: Questionnaire MpoxRegister Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire Structure LinkID Text Cardinality Type Flags Description & Constraints Mpox vaccination register questionnaire Questionnaire http://example.org/Questionnaire/MpoxRegister#0.1.0 #xD; 151479012557 Reporting Site 0..1 group #xD; 546255966914 Hospital/Facility Location 0..1 display #xD; user_role User Role 0..1 string #xD; user_facility User Facility 0..1 string #xD; user_ward User Ward 0..1 string #xD; user_sub_county User Sub County 0..1 string #xD; user_county User County 0..1 string #xD; facility_level null 0..1 group Enable When: user_role = VACCINATOR #xD; 294367770999 County 1..1 reference #xD; 819946803642 Sub County 1..1 reference #xD; 819943434 Ward 1..1 reference #xD; 819946803677 Health Facility 1..1 reference #xD; 438862163919 Type of health facility 1..1 choice Options: 3 options #xD; sub_county_level null 0..1 group Enable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER #xD; 294367770999_sub_county County 1..1 reference #xD; 819946803642_sub_county Sub County 1..1 reference #xD; 819943434_sub_county Ward 1..1 reference #xD; 819946803677_sub_county Health Facility 1..1 reference #xD; 438862163919_sub_county Type of health facility 1..1 choice Options: 3 options #xD; county_level null 0..1 group Enable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER #xD; 294367770999_county County 1..1 reference #xD; 819946803642_county Sub County 1..1 reference #xD; 819943434_county Ward 1..1 reference #xD; 819946803677_county Health Facility 1..1 reference #xD; 438862163919_county Type of health facility 1..1 choice Options: 3 options #xD; national_level null 0..1 group Enable When: user_role = ADMINISTRATOR #xD; 294367770999_national County 1..1 reference #xD; 819946803642_national Sub County 1..1 reference #xD; 819943434_national Ward 1..1 reference #xD; 819946803677_national Health Facility 1..1 reference #xD; 438862163919_national Type of health facility 1..1 choice Options: 3 options #xD; 992818778559 EPID No 0..1 string #xD; client_information Client Information 0..1 group #xD; 873240407472 First Name 1..1 string #xD; 246751846436 Middle Name 0..1 string #xD; 486402457213 Last Name 1..1 string #xD; dob_known Is Date of Birth known? 1..1 choice Options: 2 options #xD; 257830485990 Date of Birth 1..1 date Enable When: dob_known = Yes (yes) #xD; calculated_age Age 1..1 string Enable When: dob_known = Yes (yes) #xD; age-group Age Details 0..1 group Enable When: dob_known = No (no) #xD; 492731638700 Age in Years 1..1 integer #xD; 185726989867 Age in Months 0..1 integer #xD; 828303331247 Age in Days 0..1 integer #xD; 929966324957 Gender 0..1 choice Options: 2 options #xD; occupation Occupation 1..1 choice Options: 4 options #xD; occupation-other Please specify other occupation 1..1 string Enable When: occupation = Other (occupation-codes#OTH) #xD; nationality Nationality 0..1 choice Options: 2 options #xD; country_of_origin If Non-Kenyan, specify country of origin 1..1 string Enable When: nationality = Non-Kenyan (unknown#NON) #xD; patient-identify-type Identification Type 1..1 choice Options: 2 options #xD; PR-id-value Identification Number 1..1 string #xD; a4-county County 1..1 reference Enable When: nationality = Kenyan (unknown#KE) #xD; a3-sub-county Sub County 1..1 reference Enable When: nationality = Kenyan (unknown#KE) #xD; a2-ward Ward 1..1 reference Enable When: nationality = Kenyan (unknown#KE) #xD; PR-address-village Village 1..1 string #xD; 754217593839 Phone Number 1..1 string #xD; 2.1 07xxxxxxxx 0..1 display #xD; location_widget GPS Coordinate 0..1 group #xD; latitude Latitude 0..1 decimal #xD; longitude Longitude 0..1 decimal #xD; screening Screening 0..1 group #xD; contact_mpox Contact of Mpox Case 0..1 choice Options: 2 options #xD; allergic_history Allergic History 0..1 choice Options: 2 options #xD; dosage Dose Information 0..1 group #xD; vaccine_name Vaccine name 0..1 choice Options: 3 options #xD; date_given Date Given 1..1 date #xD; batch_no Batch Number 1..1 string #xD; vaccination_center Name of Vaccination Center 1..1 string #xD; supervisor_name Supervisor Name 1..1 string #xD; supervisor_level Supervisor Level 1..1 choice Options: 4 options #xD; Documentation for this format Options Sets Answer options for 438862163919 null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_sub_county null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_county null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for 438862163919_national null#Private ("Private") null#Public ("Public") null#Faith Based ("Faith Based") Answer options for dob_known null#yes ("Yes") null#no ("No") Answer options for 929966324957 http://hl7.org/fhir/administrative-gender#female ("Female") http://hl7.org/fhir/administrative-gender#male ("Male") Answer options for occupation http://example.org/fhir/CodeSystem/occupation-codes#HCW ("Health Care Worker") http://example.org/fhir/CodeSystem/occupation-codes#SW ("Sex Worker") http://example.org/fhir/CodeSystem/occupation-codes#TD ("Truck Driver") http://example.org/fhir/CodeSystem/occupation-codes#OTH ("Other") Answer options for nationality urn:iso:std:iso:3166#KE ("Kenyan") urn:iso:std:iso:3166#NON ("Non-Kenyan") Answer options for patient-identify-type http://hl7.org/fhir/administrative-identifier#nationalId ("National ID") http://hl7.org/fhir/administrative-identifier#passport ("Passport") Answer options for contact_mpox http://terminology.hl7.org/CodeSystem/v2-0136#yes ("Yes") http://terminology.hl7.org/CodeSystem/v2-0136#no ("No") Answer options for allergic_history http://terminology.hl7.org/CodeSystem/v2-0136#yes ("Yes") http://terminology.hl7.org/CodeSystem/v2-0136#no ("No") Answer options for vaccine_name null#MVA-BN ("MVA-BN") null#LC16 ("LC16") null#ACAM2000 ("ACAM 2000") Answer options for supervisor_level null#National ("National") null#County ("County") null#Sub County ("Sub County") null#Partner ("Partner")
If Non-Kenyan, specify country of origin
Enter a valid mobile number. Strings and special characters aren't allowed