# 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, )
* Social Security Number/123-45-9999
 | | |
| 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"
    }
  },
  {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "SS",
        "display" : "Social Security Number"
      }],
      "text" : "Social Security Number"
    },
    "system" : "http://hl7.org/fhir/sid/us-ssn",
    "value" : "123-45-9999"
  }],
  "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
  }]
}

```
