Generated Narrative: Questionnaire ANCB6

LinkID	Text	Cardinality	Type	Description & Constraints
ANCB6	If this is the woman’s first ANC contact, the health worker records information on her current pregnancy, past medical and obstetric history, medications, behaviour, immunization status and other background information.		Questionnaire	http://fhir.org/guides/who/anc-cds/Questionnaire/ANCB6#0.3.0
1	Highest level of education achieved	0..1	choice	Definition: Patient.educationLevel Value Set: Highest level of education achieved Choices
2	Occupation	0..1	choice	Definition: Patient.occupation Value Set: Occupation Choices Grouper
3	Last menstrual period (LMP) date	0..1	date	Definition: Observation.value[x]
4	Ultrasound done	0..1	boolean	Definition: Observation.value[x]
5	Ultrasound date	0..1	date	Definition: Procedure.performed[x]
6	Gestational age	0..1	quantity	Definition: Observation.value[x]
7	Source of gestational age	0..1	choice	Definition: Observation.value[x] Value Set: Source of gestational age Choices
8	Expected date of delivery (EDD)	0..1	date	Definition: Observation.value[x]
9	Number of pregnancies (gravida)	0..1	integer	Definition: Observation.value[x]
10	Number of miscarriages and/or abortions	0..1	integer	Definition: Observation.value[x]
11	Number of live births	0..1	integer	Definition: Observation.value[x]
12	Whether last live birth was preterm	0..1	choice	Definition: Observation.value[x] Value Set: Whether last live birth was preterm Choices
13	Number of stillbirths	0..1	integer	Definition: Observation.value[x]
14	Parity	0..1	integer	Definition: Observation.value[x]
15	Number of caesarian sections	0..1	integer	Definition: Observation.value[x]
16	Past pregnancy complications	0..1	choice	Definition: Observation.value[x] Value Set: Past pregnancy complications Choices Grouper
17	Substance use during past pregnancy specification	0..1	choice	Definition: Observation.value[x] Value Set: Substance use during past pregnancy specification Choices
18	Allergies	0..1	choice	Definition: Observation.value[x] Value Set: Allergies Choices
19	Past surgeries	0..1	choice	Definition: Observation.value[x] Value Set: Past surgeries Choices
20	Existing chronic health conditions	0..1	choice	Definition: Observation.value[x] Value Set: Existing chronic health conditions Choices Grouper
21	HIV diagnosis date	0..1	choice	Definition: Observation.value[x]
22	Tetanus toxoid-containing vaccine (TTCV) immunization history	0..1	choice	Definition: Observation.value[x] Value Set: Tetanus toxoid-containing vaccine (TTCV) immunization history Choices Grouper
23	Flu immunization history	0..1	choice	Definition: Observation.value[x] Value Set: Flu immunization history Choices Grouper
24	Current medications	0..1	choice	Definition: Observation.value[x] Value Set: Current medications Choices Grouper
25	Daily caffeine intake	0..1	choice	Definition: Observation.value[x] Value Set: Daily caffeine intake Choices Grouper
26	Clinical enquiry for alcohol and other substance use done	0..1	choice	Definition: Observation.value[x]
27	Current alcohol and/or other substance use	0..1	choice	Definition: Observation.value[x] Value Set: Current alcohol and/or other substance use Choices Grouper
28	Tobacco use	0..1	boolean	Definition: Observation.value[x]
29	Recently quit tobacco products	0..1	boolean	Definition: Observation.value[x]
30	Exposure to second-hand smoke	0..1	boolean	Definition: Observation.value[x]
31	Partner HIV status (reported)	0..1	choice	Definition: Observation.value[x] Value Set: Partner HIV status (reported) Choices Grouper
32	Contraceptive use of male condoms	0..1	boolean	Definition: Observation.value[x]
33	Contraceptive use of female condoms	0..1	boolean	Definition: Observation.value[x]
Documentation for this format

Form: ANC.B6 Profile - Form