<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="fod-correction-example"/>
  <meta>
    <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-notification-bundle"/>
  </meta>
  <language value="en"/>
  <identifier>
    <extension url="http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CertificateNumber">
      <valueString value="000999"/>
    </extension>
    <system value="http://vitalrecords.example.gov/fod-notification"/>
    <value value="IL-FOD-2026-0000999"/>
  </identifier>
  <type value="message"/>
  <timestamp value="2026-09-10T09:12:00-05:00"/>
  <entry>
    <fullUrl value="urn:uuid:b638f439-d271-423d-863a-987a44857511"/>
    <resource>
      <MessageHeader>
        <id value="IL-FOD-2026-0000999"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-message-header"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="MessageHeader_IL-FOD-2026-0000999"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: MessageHeader IL-FOD-2026-0000999</b>
                        </p>
                        <a name="IL-FOD-2026-0000999"/>
                        <a name="hcIL-FOD-2026-0000999"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-message-header.html">Fact of Death Message Header</a></p>
                        </div>
                        <p>
                            <b>event</b>: <a href="CodeSystem-fod-notification-event-cs.html#fod-notification-event-cs-fact-of-death-notification">Fact of Death Notification Event Codes: fact-of-death-notification</a> (Fact of Death Notification)</p>
                        <h3>Destinations</h3>
                        <table class="grid">
                            <tr>
                                <td style="display: none">-</td>
                                <td>
                                    <b>Name</b>
                                </td>
                                <td>
                                    <b>Endpoint</b>
                                </td>
                                <td>
                                    <b>Receiver</b>
                                </td>
                            </tr>
                            <tr>
                                <td style="display: none">*</td>
                                <td>Example Health System</td>
                                <td>
                                    <a href="https://ehr.example.org/fhir/$process-message">https://ehr.example.org/fhir/$process-message</a>
                                </td>
                                <td>Example Health System</td>
                            </tr>
                        </table>
                        <p>
                            <b>sender</b>: <a href="Bundle-fod-notification-home-partial-date-example.html#urn-uuid-5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a">Illinois Department of Public Health, Division of Vital Records</a></p>
                        <h3>Sources</h3>
                        <table class="grid">
                            <tr>
                                <td style="display: none">-</td>
                                <td>
                                    <b>Name</b>
                                </td>
                                <td>
                                    <b>Endpoint</b>
                                </td>
                            </tr>
                            <tr>
                                <td style="display: none">*</td>
                                <td>Illinois Vital Records Notification Service</td>
                                <td>
                                    <a href="https://vitalrecords.example.gov/fod">https://vitalrecords.example.gov/fod</a>
                                </td>
                            </tr>
                        </table>
                        <p>
                            <b>focus</b>: <a href="Bundle-fod-notification-hospital-example2.html#urn-uuid-2b3c4d5e-6f70-4812-9345-6a7b8c9d0e1f">Observation Date+time of death</a></p>
                    </div>
        </text>
        <eventCoding>
          <system value="http://somewhere.org/fhir/us/fod/CodeSystem/fod-notification-event-cs"/>
          <code value="fact-of-death-notification"/>
        </eventCoding>
        <destination>
          <name value="Example Health System"/>
          <endpoint value="https://ehr.example.org/fhir/$process-message"/>
          <receiver>
            <display value="Example Health System"/>
          </receiver>
        </destination>
        <sender>
          <reference value="urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a"/>
          <display value="Illinois Department of Public Health, Division of Vital Records"/>
        </sender>
        <source>
          <name value="Illinois Vital Records Notification Service"/>
          <endpoint value="https://vitalrecords.example.gov/fod"/>
        </source>
        <focus>
          <reference value="urn:uuid:2b3c4d5e-6f70-4812-9345-6a7b8c9d0e1f"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1a2b3c4d-5e6f-4708-9192-a3b4c5d6e7f9"/>
    <resource>
      <Patient>
        <id value="fod-decedent-hospital-example"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-decedent"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="Patient_fod-decedent-hospital-example"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: Patient fod-decedent-hospital-example</b>
                        </p>
                        <a name="fod-decedent-hospital-example"/>
                        <a name="hcfod-decedent-hospital-example"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-decedent.html">Fact of Death Decedent</a></p>
                        </div>
                        <p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Alice Rose Nakamura (official) Female, DoB: 1970-01-01 ( Social Security number)</p>
                        <hr/>
                        <table class="grid">
                            <tr>
                                <td style="background-color: #f3f5da" title="Known status of Patient">Deceased:</td>
                                <td colspan="3">true</td>
                            </tr>
                            <tr>
                                <td style="background-color: #f3f5da" title="Alternate names (see the one above)">Alt. Name:</td>
                                <td colspan="3">Alice Whitfield (Name changed for Marriage)</td>
                            </tr>
                            <tr>
                                <td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td>
                                <td colspan="3">
                                    <ul>
                                        <li>ph: 217-555-0142(Home)</li>
                                        <li>1428 Elm Street Springfield IL 62704 US </li>
                                    </ul>
                                </td>
                            </tr>
                        </table>
                    </div>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="SS"/>
            </coding>
          </type>
          <system value="http://hl7.org/fhir/sid/us-ssn"/>
          <value value="999451234"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="TestLast"/>
          <given value="TestFirst"/>
        </name>
        <name>
          <use value="maiden"/>
          <family value="Washington"/>
          <given value="TestFirst"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="217-555-0142"/>
          <use value="home"/>
        </telecom>
        <gender value="female"/>
        <birthDate value="1970-01-01"/>
        <deceasedBoolean value="true"/>
        <address>
          <line value="1428 Elm Street"/>
          <city value="Springfield"/>
          <district value="Sangamon"/>
          <state value="IL"/>
          <postalCode value="62704"/>
          <country value="US"/>
        </address>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:2b3c4d5e-6f70-4812-9345-6a7b8c9d0e1f"/>
    <resource>
      <Observation>
        <id value="fod-death-date-hospital-example"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-death-date"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="Observation_fod-death-date-hospital-example"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: Observation fod-death-date-hospital-example</b>
                        </p>
                        <a name="fod-death-date-hospital-example"/>
                        <a name="hcfod-death-date-hospital-example"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-death-date.html">Fact of Death Death Date</a></p>
                        </div>
                        <p>
                            <b>Event Location</b>: <a href="Bundle-fod-notification-hospital-example2.html#urn-uuid-3c4d5e6f-7081-4923-a456-7b8c9d0e1f20">Location Springfield General Hospital</a></p>
                        <p>
                            <b>status</b>: Final</p>
                        <p>
                            <b>code</b>: <span title="Codes:{http://loinc.org 81956-5}">Date+time of death</span></p>
                        <p>
                            <b>subject</b>: <a href="Bundle-fod-notification-hospital-example2.html#urn-uuid-1a2b3c4d-5e6f-4708-9192-a3b4c5d6e7f9">Alice Rose Nakamura (official) Female, DoB: 1970-01-01 ( Social Security number)</a></p>
                        <p>
                            <b>value</b>: 2026-08-29 14:22:00-0500</p>
                        <p>
                            <b>method</b>: <span title="Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-date-of-death-determination-methods-cs exact}">Exact</span></p>
                        <blockquote>
                            <p>
                                <b>component</b>
                            </p>
                            <p>
                                <b>code</b>: <span title="Codes:{http://loinc.org 80616-6}">Date and time pronounced dead [US Standard Certificate of Death]</span></p>
                            <p>
                                <b>value</b>: 2026-08-29 14:35:00-0500</p>
                        </blockquote>
                        <blockquote>
                            <p>
                                <b>component</b>
                            </p>
                            <p>
                                <b>code</b>: <span title="Codes:{http://loinc.org 58332-8}">Location of death</span></p>
                            <p>
                                <b>value</b>: <span title="Codes:{http://snomed.info/sct 16983000}">Death in hospital</span></p>
                        </blockquote>
                    </div>
        </text>
        <extension url="http://hl7.org/fhir/StructureDefinition/event-location">
          <valueReference>
            <reference value="urn:uuid:3c4d5e6f-7081-4923-a456-7b8c9d0e1f20"/>
          </valueReference>
        </extension>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="81956-5"/>
            <display value="Date+time of death"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:1a2b3c4d-5e6f-4708-9192-a3b4c5d6e7f9"/>
        </subject>
        <valueDateTime value="2026-08-29T14:22:00-05:00"/>
        <method>
          <coding>
            <system value="http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-date-of-death-determination-methods-cs"/>
            <code value="exact"/>
            <display value="Exact"/>
          </coding>
        </method>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="80616-6"/>
              <display value="Date and time pronounced dead [US Standard Certificate of Death]"/>
            </coding>
          </code>
          <valueDateTime value="2026-08-29T14:35:00-05:00"/>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="58332-8"/>
              <display value="Location of death"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="16983000"/>
              <display value="Death in hospital"/>
            </coding>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:3c4d5e6f-7081-4923-a456-7b8c9d0e1f20"/>
    <resource>
      <Location>
        <id value="fod-death-location-hospital-example"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-death-location"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="Location_fod-death-location-hospital-example"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: Location fod-death-location-hospital-example</b>
                        </p>
                        <a name="fod-death-location-hospital-example"/>
                        <a name="hcfod-death-location-hospital-example"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-death-location.html">Fact of Death Death Location</a></p>
                        </div>
                        <p>
                            <b>name</b>: Springfield General Hospital</p>
                        <p>
                            <b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-location-type-cs death}">Death Location</span></p>
                        <p>
                            <b>address</b>: 800 North Rutledge Street Springfield IL 62702 US </p>
                    </div>
        </text>
        <name value="Springfield General Hospital"/>
        <type>
          <coding>
            <system value="http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-location-type-cs"/>
            <code value="death"/>
          </coding>
        </type>
        <address>
          <line value="800 North Rutledge Street"/>
          <city value="Springfield"/>
          <district value="Sangamon"/>
          <state value="IL"/>
          <postalCode value="62702"/>
          <country value="US"/>
        </address>
      </Location>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a"/>
    <resource>
      <Organization>
        <id value="fod-source-organization-example"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-source-organization"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="Organization_fod-source-organization-example"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: Organization fod-source-organization-example</b>
                        </p>
                        <a name="fod-source-organization-example"/>
                        <a name="hcfod-source-organization-example"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-source-organization.html">Fact of Death Source Organization</a></p>
                        </div>
                        <p>
                            <b>identifier</b>: <code>http://vitalrecords.example.gov/jurisdiction-id</code>/IL</p>
                        <p>
                            <b>active</b>: true</p>
                        <p>
                            <b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/organization-type govt}">Government</span></p>
                        <p>
                            <b>name</b>: Illinois Department of Public Health, Division of Vital Records</p>
                        <p>
                            <b>telecom</b>: ph: 217-555-0100</p>
                        <p>
                            <b>address</b>: 925 East Ridgely Avenue Springfield IL 62702 US </p>
                    </div>
        </text>
        <identifier>
          <system value="http://vitalrecords.example.gov/jurisdiction-id"/>
          <value value="IL"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="govt"/>
            <display value="Government"/>
          </coding>
        </type>
        <name value="Illinois Department of Public Health, Division of Vital Records"/>
        <telecom>
          <system value="phone"/>
          <value value="217-555-0100"/>
        </telecom>
        <address>
          <line value="925 East Ridgely Avenue"/>
          <city value="Springfield"/>
          <state value="IL"/>
          <postalCode value="62702"/>
          <country value="US"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:4e5f6071-8293-4a45-b567-8c9d0e1f2031"/>
    <resource>
      <Provenance>
        <id value="fod-provenance-hospital-example"/>
        <meta>
          <profile value="http://somewhere.org/fhir/us/fod/StructureDefinition/fod-provenance"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">
                        <a name="Provenance_fod-provenance-hospital-example"/>
                        <p class="res-header-id">
                            <b>Generated Narrative: Provenance fod-provenance-hospital-example</b>
                        </p>
                        <a name="fod-provenance-hospital-example"/>
                        <a name="hcfod-provenance-hospital-example"/>
                        <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%">
                            <p style="margin-bottom: 0px"/>
                            <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-fod-provenance.html">Fact of Death Provenance</a></p>
                        </div>
                        <p>Provenance for <a href="Bundle-fod-notification-hospital-example2.html#urn-uuid-2b3c4d5e-6f70-4812-9345-6a7b8c9d0e1f">Observation Date+time of death</a></p>
                        <p>Summary</p>
                        <table class="grid">
                            <tr>
                                <td>Occurrence</td>
                                <td>2026-09-01</td>
                            </tr>
                            <tr>
                                <td>Recorded</td>
                                <td>2026-09-10 09:12:00-0500</td>
                            </tr>
                        </table>
                        <p>
                            <b>Agents</b>
                        </p>
                        <table class="grid">
                            <tr>
                                <td>
                                    <b>Type</b>
                                </td>
                                <td>
                                    <b>who</b>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}">Author</span>
                                </td>
                                <td>
                                    <a href="Bundle-fod-notification-home-partial-date-example.html#urn-uuid-5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a">Organization Illinois Department of Public Health, Division of Vital Records</a>
                                </td>
                            </tr>
                        </table>
                    </div>
        </text>
        <target>
          <reference value="urn:uuid:2b3c4d5e-6f70-4812-9345-6a7b8c9d0e1f"/>
        </target>
        <occurredDateTime value="2026-09-01"/>
        <recorded value="2026-09-10T09:12:00-05:00"/>
        <agent>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
              <code value="author"/>
            </coding>
          </type>
          <who>
            <reference value="urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a"/>
          </who>
        </agent>
      </Provenance>
    </resource>
  </entry>
</Bundle>