# patient-betsysmith-johnson01 - PACIO Sample Data Depot v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **patient-betsysmith-johnson01**

## Example Patient: patient-betsysmith-johnson01

Last updated: 2021-03-29 14:25:34-0500; Language: en-US

Profile: [US Core Patient Profile](http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html)

Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)

-------

| | | | |
| :--- | :--- | :--- | :--- |
| Active: | true | Marital Status: | unknown |
| Other Ids: | * Medical Record Number/1032702 (use: usual, )
* [United States Social Security Number](http://terminology.hl7.org/6.1.0/NamingSystem-ssn.html)/SS
 | | |
| Contact Detail | * ph: 555-555-1111(Mobile)
* [mmoen+betsysmithjohnson@mydirectives.com](mailto:mmoen+betsysmithjohnson@mydirectives.com)
* 17040 E Warren Avenue, Detroit, MI 48224
 | | |
| Language: | English(preferred) | | |
| son: | * Charles Johnson
* 17040 E Warren Avenue, Detroit, MI 48224
* ph: (555) 555-2222
 | | |
| daughter in-law: | * Lisa Johnson
* 17040 E Warren Avenue, Detroit, MI 48224
* ph: (555) 555-3333
 | | |
| US Core Race Extension: | * ombCategory: [Race & Ethnicity - CDC: 2106-3](http://hl7.org/fhir/us/core/STU4/CodeSystem-cdcrec.html#cdcrec-2106-3) (White)
* text: White
 | | |



## Resource Content

```json
{
  "resourceType" : "Patient",
  "id" : "patient-betsysmith-johnson01",
  "meta" : {
    "lastUpdated" : "2021-03-29T14:25:34.001-05:00",
    "profile" : [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
    ]
  },
  "language" : "en-US",
  "extension" : [
    {
      "extension" : [
        {
          "url" : "ombCategory",
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.6.238",
            "code" : "2106-3",
            "display" : "White"
          }
        },
        {
          "url" : "text",
          "valueString" : "White"
        }
      ],
      "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
    }
  ],
  "identifier" : [
    {
      "use" : "usual",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MR",
            "display" : "Medical Record Number"
          }
        ],
        "text" : "Medical Record Number"
      },
      "system" : "http://hospital.smarthealthit.org",
      "value" : "1032702"
    },
    {
      "system" : "http://hl7.org/fhir/sid/us-medicare",
      "value" : "1PA3D58WH16",
      "assigner" : {
        "display" : "Medicare"
      }
    },
    {
      "system" : "http://hl7.org/fhir/sid/us-ssn",
      "value" : "SS"
    }
  ],
  "active" : true,
  "name" : [
    {
      "use" : "usual",
      "text" : "Smith-Johnson, Betsy",
      "family" : "Smith-Johnson",
      "given" : ["Betsy"]
    }
  ],
  "telecom" : [
    {
      "system" : "phone",
      "value" : "555-555-1111",
      "use" : "mobile"
    },
    {
      "system" : "email",
      "value" : "mmoen+betsysmithjohnson@mydirectives.com",
      "use" : "mobile"
    }
  ],
  "gender" : "female",
  "birthDate" : "1950-11-15",
  "address" : [
    {
      "text" : "17040 E Warren Avenue, Detroit, MI 48224",
      "line" : ["17040 E Warren Avenue"],
      "city" : "Detroit",
      "state" : "MI",
      "postalCode" : "48224",
      "country" : "US",
      "period" : {
        "start" : "2016-12-06"
      }
    }
  ],
  "maritalStatus" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code" : "UNK"
      }
    ]
  },
  "contact" : [
    {
      "relationship" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
              "code" : "SONC"
            }
          ]
        }
      ],
      "name" : {
        "text" : "Charles Johnson"
      },
      "telecom" : [
        {
          "system" : "phone",
          "value" : "(555) 555-2222"
        }
      ],
      "address" : {
        "text" : "17040 E Warren Avenue, Detroit, MI 48224"
      }
    },
    {
      "relationship" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
              "code" : "DAUINLAW"
            }
          ]
        }
      ],
      "name" : {
        "text" : "Lisa Johnson"
      },
      "telecom" : [
        {
          "system" : "phone",
          "value" : "(555) 555-3333"
        }
      ],
      "address" : {
        "text" : "17040 E Warren Avenue, Detroit, MI 48224"
      }
    }
  ],
  "communication" : [
    {
      "language" : {
        "coding" : [
          {
            "system" : "urn:ietf:bcp:47",
            "code" : "en",
            "display" : "English"
          }
        ]
      },
      "preferred" : true
    }
  ]
}

```
