SMART ICVP, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-icvp/ and changes regularly. See the Directory of published versions
Example QuestionnaireResponse: ICVPQRExample
Profile: SDC Questionnaire Response
Tag: lformsVersion: 33.3.6 (Details: [not stated] code lformsVersion: 33.3.6)
| LinkID | Text | Definition | Answer |
|---|---|---|---|
  ICVPQRExample | Questionnaire:ICVP Model Questionnaire | ||
  name | Full Name of the client | John Doe | |
| dob | Date of Birth | 2017-05-17 | |
| sex | Sex | administrativeSex: M (Male) | |
| nationality | Nationality | ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: ATG (Antigua and Barbuda) | |
| nid | National Identification Document | ASVPR24682C | |
 guardian | Parent or Guardian Details | ||
 guardianName | Name of Parent or Guardian | Father Doe | |
 guardianRelationship | Relationship Status | DVCRelationshipStatus: Parent (Parent) | |
| vaccineDetails | Vaccine Certificate Details | ||
 productID | Vaccine or Prophylaxis ID | ICVPProductIds: YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0 (01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé) | |
| date | Date of Vaccination | 2025-08-08 | |
| clinicianName | Name of supervising clinician | Mr. Supervisor | |
| issuer | Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center | National Health Institute | |
| batchNo | Batch Number | 23543657LOT | |
| validityPeriod | Certificate Validity Period | ||
| startDate | From | 2025-08-15 | |
| Documentation for this format | |||