{ "resourceType" : "Bundle", "id" : "fod-notification-home-partial-date-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-notification-bundle"] }, "identifier" : { "extension" : [{ "url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CertificateNumber", "valueString" : "002911" }], "system" : "http://vitalrecords.example.gov/fod-notification", "value" : "IL-FOD-2026-0002911" }, "type" : "message", "timestamp" : "2026-08-06T16:40:00-05:00", "entry" : [{ "fullUrl" : "urn:uuid:a0b1c2d3-e4f5-4607-8819-2a3b4c5d6e7f", "resource" : { "resourceType" : "MessageHeader", "id" : "IL-FOD-2026-0002911", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-message-header"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: MessageHeader IL-FOD-2026-0002911

Profile: Fact of Death Message Header

event: Fact of Death Notification Event Codes: fact-of-death-notification (Fact of Death Notification)

Destinations

-NameEndpoint
*Prairie Family Medicinehttps://ehr.example.org/fhir/$process-message

sender: Illinois Department of Public Health, Division of Vital Records

Sources

-NameEndpoint
*Illinois Vital Records Notification Servicehttps://vitalrecords.example.gov/fod

focus: Observation Date+time of death

" }, "eventCoding" : { "system" : "http://example.org/fhir/us/fod/CodeSystem/fod-notification-event-cs", "code" : "fact-of-death-notification" }, "destination" : [{ "name" : "Prairie Family Medicine", "endpoint" : "https://ehr.example.org/fhir/$process-message" }], "sender" : { "reference" : "urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a", "display" : "Illinois Department of Public Health, Division of Vital Records" }, "source" : { "name" : "Illinois Vital Records Notification Service", "endpoint" : "https://vitalrecords.example.gov/fod" }, "focus" : [{ "reference" : "urn:uuid:c2d3e4f5-0617-4829-9a3b-4c5d6e7f8091" }] } }, { "fullUrl" : "urn:uuid:b1c2d3e4-f506-4718-892a-3b4c5d6e7f80", "resource" : { "resourceType" : "Patient", "id" : "fod-decedent-home-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-decedent"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Patient fod-decedent-home-example

Profile: Fact of Death Decedent

Daniel Okonjo (official) Male, DoB: 1957-11-02 ( http://vitalrecords.example.gov/death-record-id#IL-DR-2026-0002911)

Deceased:true
Contact Detail77 Larkspur Lane Decatur IL 62521 US
" }, "identifier" : [{ "system" : "http://vitalrecords.example.gov/death-record-id", "value" : "IL-DR-2026-0002911" }], "name" : [{ "use" : "official", "family" : "Okonjo", "given" : ["Daniel"] }], "gender" : "male", "birthDate" : "1957-11-02", "deceasedBoolean" : true, "address" : [{ "line" : ["77 Larkspur Lane"], "city" : "Decatur", "district" : "Macon", "state" : "IL", "postalCode" : "62521", "country" : "US" }] } }, { "fullUrl" : "urn:uuid:c2d3e4f5-0617-4829-9a3b-4c5d6e7f8091", "resource" : { "resourceType" : "Observation", "id" : "fod-death-date-home-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-death-date"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Observation fod-death-date-home-example

Profile: Fact of Death Death Date

Event Location: Location Decedent's residence

status: Final

code: Date+time of death

subject: Daniel Okonjo (official) Male, DoB: 1957-11-02 ( http://vitalrecords.example.gov/death-record-id#IL-DR-2026-0002911)

value: 2026-06

method: Approximate

Components

-CodeValue[x]
*Location of deathDeath in home
" }, "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/event-location", "valueReference" : { "reference" : "urn:uuid:d3e4f506-1728-493a-ab4c-5d6e7f809102" } }], "status" : "final", "code" : { "coding" : [{ "system" : "http://loinc.org", "code" : "81956-5", "display" : "Date+time of death" }] }, "subject" : { "reference" : "urn:uuid:b1c2d3e4-f506-4718-892a-3b4c5d6e7f80" }, "valueDateTime" : "2026-06", "_valueDateTime" : { "extension" : [{ "url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-partial-date-time-vr", "extension" : [{ "url" : "year", "valueUnsignedInt" : 2026 }, { "url" : "month", "valueUnsignedInt" : 6 }, { "url" : "day", "_valueUnsignedInt" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason", "valueCode" : "unknown" }] } }, { "url" : "time", "_valueTime" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason", "valueCode" : "unknown" }] } }] }] }, "method" : { "coding" : [{ "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-date-of-death-determination-methods-cs", "code" : "approximate", "display" : "Approximate" }] }, "component" : [{ "code" : { "coding" : [{ "system" : "http://loinc.org", "code" : "58332-8", "display" : "Location of death" }] }, "valueCodeableConcept" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "440081000124100", "display" : "Death in home" }] } }] } }, { "fullUrl" : "urn:uuid:d3e4f506-1728-493a-ab4c-5d6e7f809102", "resource" : { "resourceType" : "Location", "id" : "fod-death-location-home-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-death-location"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Location fod-death-location-home-example

Profile: Fact of Death Death Location

name: Decedent's residence

type: Death Location

address: Decatur IL US

" }, "name" : "Decedent's residence", "type" : [{ "coding" : [{ "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-location-type-cs", "code" : "death" }] }], "address" : { "city" : "Decatur", "district" : "Macon", "state" : "IL", "country" : "US" } } }, { "fullUrl" : "urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a", "resource" : { "resourceType" : "Organization", "id" : "fod-source-organization-home-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-source-organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization fod-source-organization-home-example

Profile: Fact of Death Source Organization

identifier: http://vitalrecords.example.gov/jurisdiction-id/IL

active: true

type: Government

name: Illinois Department of Public Health, Division of Vital Records

telecom: ph: 217-555-0100

" }, "identifier" : [{ "system" : "http://vitalrecords.example.gov/jurisdiction-id", "value" : "IL" }], "active" : true, "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "govt", "display" : "Government" }] }], "name" : "Illinois Department of Public Health, Division of Vital Records", "telecom" : [{ "system" : "phone", "value" : "217-555-0100" }] } }, { "fullUrl" : "urn:uuid:e4f50617-2839-4a4b-bc5d-6e7f80910213", "resource" : { "resourceType" : "Provenance", "id" : "fod-provenance-home-example", "meta" : { "profile" : ["http://example.org/fhir/us/fod/StructureDefinition/fod-provenance"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Provenance fod-provenance-home-example

Profile: Fact of Death Provenance

Provenance for Observation Date+time of death

Summary

Occurrence2026-08-04
Recorded2026-08-06 16:40:00-0500

Agents

Typewho
AuthorOrganization Illinois Department of Public Health, Division of Vital Records
" }, "target" : [{ "reference" : "urn:uuid:c2d3e4f5-0617-4829-9a3b-4c5d6e7f8091" }], "occurredDateTime" : "2026-08-04", "recorded" : "2026-08-06T16:40:00-05:00", "agent" : [{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type", "code" : "author" }] }, "who" : { "reference" : "urn:uuid:5d4c3b2a-1908-4716-8524-3f2e1d0c9b8a" } }] } }] }