Consolidated CDA (C-CDA)
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: History and Physical Complete Header Example - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

# 
 Title:        History and Physical
 Based on:     C-CDA_R2_History_and_Physical.xml

 Updated for C-CDA R3.0 with a focus on header elements
  - required/suggested sections are populated with nullFlavor="NI"
	  to demonstrate WHICH sections should be included, but they
		all contain "No information" as this is an example of the header
  
 ********************************************************
 Disclaimer: This sample file contains representative data elements to represent a History and Physical. 
 The file depicts a fictional character's health data. Any resemblance to a real person is coincidental. 
 To illustrate as many data elements as possible, the clinical scenario may not be plausible. 
 The data in this sample file is not intended to represent real patients, people or clinical events. 
 This sample is designed to be used in conjunction with the C-CDA Clinical Notes Implementation Guide.
 ********************************************************
 

 a fhir:ClinicalDocument ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:realmCode ( [
fhir:code [ fhir:v "US" ]
  ] ) ; # 
#********************************************************
#  CDA Header
#********************************************************
#	
  fhir:typeId [
fhir:extension [ fhir:v "POCD_HD000040" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.1.3" ]
  ] ; # 
  fhir:templateId ( [
fhir:extension [ fhir:v "2024-05-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.1.1" ]
  ] [
fhir:extension [ fhir:v "2024-05-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.1.3" ]
  ] ) ; #  US General Header Template 
  fhir:id [
fhir:extension [ fhir:v "TT988" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19.5.99999.1" ]
  ] ; # 
  fhir:code [
fhir:code [ fhir:v "34117-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "History and Physical Note" ]
  ] ; # 
  fhir:title [
fhir:xmlText [ fhir:v "Community Health and Hospitals: History & Physical" ]
  ] ; # 
  fhir:effectiveTime [
fhir:value [ fhir:v "2012-09-16T19:05:00-04:00"^^xsd:dateTime ]
  ] ; # 
  fhir:confidentialityCode [
fhir:code [ fhir:v "N" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.25" ]
  ] ; # 
  fhir:languageCode [
fhir:code [ fhir:v "en-US" ]
  ] ; # 
  fhir:setId [
fhir:extension [ fhir:v "sTT988" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19.5.99999.19" ]
  ] ; # 
  fhir:versionNumber [
fhir:value [ fhir:v "1"^^xsd:integer ]
  ] ; # 
  fhir:recordTarget ( [
fhir:patientRole [
      ( fhir:id [
fhir:extension [ fhir:v "998991" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19.5.99999.2" ]       ] [
fhir:extension [ fhir:v "111-00-2330" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.1" ]       ] ) ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "HP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1357 Amber Drive" ]           ] #  HP is \"primary home\" from codeSystem 2.16.840.1.113883.5.1119          ] [
fhir:city [
fhir:xmlText [ fhir:v "Beaverton" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "97867" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ; #  Fake Social Security Number using the actual SSN OID. ,  US is \"United States\" from ISO 3166-1 Country Codes: 1.0.3166.1 
      ( fhir:telecom [
        ( fhir:use [ fhir:v "HP" ] ) ;
fhir:value [ fhir:v "tel:(816)276-6909"^^xsd:anyURI ]       ] ) ;
fhir:patient [
        ( fhir:name [
          ( fhir:use [ fhir:v "L" ] ) ;
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Isabella" ]             ] ) #  L is \"Legal\" from HL7 EntityNameUse 2.16.840.1.113883.5.45            ] [
            ( fhir:given [
fhir:xmlText [ fhir:v "Isa" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Jones" ]             ] ) #  CL is \"Call me\" from HL7 EntityNamePartQualifier 2.16.840.1.113883.5.43            ] )         ] ) ;
fhir:administrativeGenderCode [
fhir:code [ fhir:v "F" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.1" ] ;
fhir:displayName [ fhir:v "Female" ]         ] ;
fhir:birthTime [
fhir:value [ fhir:v "2005-05-01"^^xsd:date ]         ] ;
fhir:maritalStatusCode [
fhir:code [ fhir:v "M" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.2" ] ;
fhir:codeSystemName [ fhir:v "MaritalStatusCode" ] ;
fhir:displayName [ fhir:v "Married" ]         ] ;
fhir:religiousAffiliationCode [
fhir:code [ fhir:v "1013" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.1076" ] ;
fhir:codeSystemName [ fhir:v "HL7 Religious Affiliation" ] ;
fhir:displayName [ fhir:v "Christian (non-Catholic, non-specific)" ]         ] ;
fhir:raceCode [
fhir:code [ fhir:v "1002-5" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
fhir:displayName [ fhir:v "American Indian or Alaska Native" ]         ] ;
        ( fhir:sdtcRaceCode [
fhir:code [ fhir:v "1966-1" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
fhir:displayName [ fhir:v "Aleut" ]         ] ) ;
fhir:ethnicGroupCode [
fhir:code [ fhir:v "2186-5" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.238" ] ;
fhir:codeSystemName [ fhir:v "Race & Ethnicity - CDC" ] ;
fhir:displayName [ fhir:v "Not Hispanic or Latino" ]         ] ;
        ( fhir:guardian [
fhir:code [
fhir:code [ fhir:v "GRPRN" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.111" ] ;
fhir:codeSystemName [ fhir:v "HL7 Role code" ] ;
fhir:displayName [ fhir:v "Grandparent" ]           ] ;
          ( fhir:addr [
            ( fhir:use [ fhir:v "HP" ] ) ;
            ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1357 Amber Drive" ]               ] #  HP is \"primary home\" from codeSystem 2.16.840.1.113883.5.1119              ] [
fhir:city [
fhir:xmlText [ fhir:v "Beaverton" ]               ]             ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]               ]             ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "97867" ]               ]             ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]               ]             ] )           ] ) ; #  US is \"United States\" from ISO 3166-1 Country Codes: 1.0.3166.1 
          ( fhir:telecom [
            ( fhir:use [ fhir:v "HP" ] ) ;
fhir:value [ fhir:v "tel:(816)276-6909"^^xsd:anyURI ]           ] ) ;
fhir:guardianPerson [
            ( fhir:name [
              ( fhir:item [
                ( fhir:given [
fhir:xmlText [ fhir:v "Ralph" ]                 ] )               ] [
                ( fhir:family [
fhir:xmlText [ fhir:v "Jones" ]                 ] )               ] )             ] )           ]         ] ) ;
fhir:birthplace [
fhir:place [
fhir:addr [
              ( fhir:item [
fhir:city [
fhir:xmlText [ fhir:v "Beaverton" ]                 ]               ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]                 ]               ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "97867" ]                 ]               ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]                 ]               ] )             ]           ]         ] ;
        ( fhir:languageCommunication [
fhir:languageCode [
fhir:code [ fhir:v "en" ]           ] ;
fhir:modeCode [
fhir:code [ fhir:v "ESP" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.60" ] ;
fhir:codeSystemName [ fhir:v "LanguageAbilityMode" ] ;
fhir:displayName [ fhir:v "Expressed spoken" ]           ] ;
fhir:proficiencyLevelCode [
fhir:code [ fhir:v "G" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.61" ] ;
fhir:codeSystemName [ fhir:v "LanguageAbilityProficiency" ] ;
fhir:displayName [ fhir:v "Good" ]           ] ;
fhir:preferenceInd [
fhir:value [ fhir:v "true"^^xsd:boolean ]           ]         ] )       ] ; #  HP is \"primary home\" from HL7 AddressUse 2.16.840.1.113883.5.1119 
fhir:providerOrganization [
        ( fhir:id [
fhir:root [ fhir:v "2.16.840.1.113883.19.5.9999.1393" ]         ] ) ;
        ( fhir:name [
          ( fhir:item [
fhir:xmlText [ fhir:v "Community Health and Hospitals" ]           ] )         ] ) ;
        ( fhir:telecom [
          ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-5000"^^xsd:anyURI ]         ] ) ;
        ( fhir:addr [
          ( fhir:use [ fhir:v "WP" ] ) ;
          ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1001 Village Avenue" ]             ]           ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]             ]           ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]             ]           ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]             ]           ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]             ]           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:author ( [
fhir:time [
fhir:value [ fhir:v "2005-03-29T22:44:11+05:00"^^xsd:dateTime ]     ] ;
fhir:assignedAuthor [
      ( fhir:id [
fhir:extension [ fhir:v "99999999" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]       ] ) ;
fhir:code [
fhir:code [ fhir:v "200000000X" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.101" ] ;
fhir:displayName [ fhir:v "Allopathic & Osteopathic Physicians" ]       ] ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1002 Healthcare Drive" ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]       ] ) ;
fhir:assignedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:dataEnterer [
fhir:assignedEntity [
      ( fhir:id [
fhir:extension [ fhir:v "999999943252" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]       ] ) ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1001 Village Avenue" ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]       ] ) ;
fhir:assignedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ]     ]
  ] ; # 
  fhir:informant ( [
fhir:assignedEntity [
      ( fhir:id [
fhir:extension [ fhir:v "KP00017" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19.5" ]       ] ) ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1001 Village Avenue" ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]       ] ) ;
fhir:assignedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ]     ]
  ] [
fhir:relatedEntity [
fhir:classCode [ fhir:v "PRS" ] ;
fhir:code [
fhir:code [ fhir:v "SPS" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.1.11.19563" ] ;
fhir:codeSystemName [ fhir:v "Personal Relationship Role Type Value Set" ] ;
fhir:displayName [ fhir:v "SPOUSE" ]       ] ; #  classCode PRS represents a person with personal relationship with the patient. 
fhir:relatedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Frank" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Jones" ]             ] )           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:custodian [
fhir:assignedCustodian [
fhir:representedCustodianOrganization [
        ( fhir:id [
fhir:extension [ fhir:v "99999999" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]         ] ) ;
fhir:name [
          ( fhir:item [
fhir:xmlText [ fhir:v "Community Health and Hospitals" ]           ] )         ] ;
fhir:telecom [
          ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]         ] ;
fhir:addr [
          ( fhir:use [ fhir:v "WP" ] ) ;
          ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1002 Healthcare Drive" ]             ]           ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]             ]           ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]             ]           ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]             ]           ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]             ]           ] )         ]       ]     ]
  ] ; # 
  fhir:informationRecipient ( [
fhir:intendedRecipient [
fhir:informationRecipient [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ] ;
fhir:receivedOrganization [
        ( fhir:name [
          ( fhir:item [
fhir:xmlText [ fhir:v "Community Health and Hospitals" ]           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:legalAuthenticator [
fhir:time [
fhir:value [ fhir:v "2009-02-27T13:00:00+05:00"^^xsd:dateTime ]     ] ;
fhir:signatureCode [
fhir:code [ fhir:v "S" ]     ] ;
fhir:assignedEntity [
      ( fhir:id [
fhir:extension [ fhir:v "999999999" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]       ] ) ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1001 Village Avenue" ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]       ] ) ;
fhir:assignedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ]     ]
  ] ; # 
  fhir:authenticator ( [
fhir:time [
fhir:value [ fhir:v "2009-02-27T13:00:00+05:00"^^xsd:dateTime ]     ] ;
fhir:signatureCode [
fhir:code [ fhir:v "S" ]     ] ;
fhir:assignedEntity [
      ( fhir:id [
fhir:extension [ fhir:v "999999999" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.4.6" ]       ] ) ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "1001 Village Avenue" ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Portland" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "99123" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:555-555-1002"^^xsd:anyURI ]       ] ) ;
fhir:assignedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:given [
fhir:xmlText [ fhir:v "Henry" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Seven" ]             ] )           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:participant ( [
fhir:typeCode [ fhir:v "IND" ] ;
fhir:time [
fhir:low [
fhir:value [ fhir:v "1959-01-01"^^xsd:date ]       ] ;
fhir:high [
fhir:value [ fhir:v "2011-10-25"^^xsd:date ]       ]     ] ;
fhir:associatedEntity [
fhir:classCode [ fhir:v "NOK" ] ;
fhir:code [
fhir:code [ fhir:v "MTH" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.5.111" ]       ] ;
      ( fhir:addr [
        ( fhir:use [ fhir:v "WP" ] ) ;
        ( fhir:item [
fhir:streetAddressLine [
fhir:xmlText [ fhir:v "17 Daws Rd." ]           ]         ] [
fhir:city [
fhir:xmlText [ fhir:v "Beaverton" ]           ]         ] [
fhir:state [
fhir:xmlText [ fhir:v "OR" ]           ]         ] [
fhir:postalCode [
fhir:xmlText [ fhir:v "97867" ]           ]         ] [
fhir:country [
fhir:xmlText [ fhir:v "US" ]           ]         ] )       ] ) ;
      ( fhir:telecom [
        ( fhir:use [ fhir:v "WP" ] ) ;
fhir:value [ fhir:v "tel:(999)555-1212"^^xsd:anyURI ]       ] ) ;
fhir:associatedPerson [
        ( fhir:name [
          ( fhir:item [
            ( fhir:prefix [
fhir:xmlText [ fhir:v "Mrs." ]             ] )           ] [
            ( fhir:given [
fhir:xmlText [ fhir:v "Martha" ]             ] )           ] [
            ( fhir:family [
fhir:xmlText [ fhir:v "Jones" ]             ] )           ] )         ] )       ]     ]
  ] ) ; # 
  fhir:inFulfillmentOf ( [
fhir:typeCode [ fhir:v "FLFS" ] ;
fhir:order [
fhir:classCode [ fhir:v "ACT" ] ;
fhir:moodCode [ fhir:v "RQO" ] ;
      ( fhir:id [
fhir:extension [ fhir:v "12345-67890" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19" ]       ] )     ]
  ] ) ; # 
  fhir:componentOf [
fhir:encompassingEncounter [
      ( fhir:id [
fhir:extension [ fhir:v "9937012" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.19" ]       ] ) ;
fhir:code [
fhir:code [ fhir:v "99213" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.12" ] ;
fhir:codeSystemName [ fhir:v "CPT-4" ]       ] ;
fhir:effectiveTime [
fhir:low [
fhir:value [ fhir:v "2009-02-27T13:00:00+05:00"^^xsd:dateTime ]         ] ;
fhir:high [
fhir:value [ fhir:v "2009-02-27T13:00:00+05:00"^^xsd:dateTime ]         ]       ] ;
fhir:location [
fhir:healthCareFacility [
          ( fhir:id [
fhir:root [ fhir:v "2.16.540.1.113883.19.2" ]           ] )         ]       ]     ]
  ] ; # 
  fhir:component [
fhir:structuredBody [
      ( fhir:component [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.6.1" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "48765-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "ALLERGIES AND ADVERSE REACTIONS" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.5.1" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "11450-4" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "PROBLEM LIST" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "PROBLEMS" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2014-06-09" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.1.1" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "10160-0" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "HISTORY OF MEDICATION USE" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "MEDICATIONS" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2014-06-09" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.9" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "51847-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Evaluation + Plan note" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Assessment and Plan" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:root [ fhir:v "1.3.6.1.4.1.19376.1.5.3.1.3.4" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "10164-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "History of Present illness Narrative" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "History of Present Illness" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.3.1" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "30954-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "RESULTS" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "RESULTS" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.12" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "29299-5" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Reason for visit Narrative" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Reason for Visit" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.2.10" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "29545-1" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Physical Findings" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Physical Examination" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.4.1" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "8716-3" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "VITAL SIGNS" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "VITAL SIGNS" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.17" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "29762-2" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Social History" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "SOCIAL HISTORY" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.15" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "10157-6" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "History of family member diseases Narrative" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Family History" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:extension [ fhir:v "2015-08-01" ] ;
fhir:root [ fhir:v "2.16.840.1.113883.10.20.22.2.20" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "11348-0" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "History of Past illness Narrative" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Past Medical History" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:root [ fhir:v "2.16.840.1.113883.10.20.2.5" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "10210-3" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Physical findings of General status Narrative" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "General Status" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] [
fhir:section [
fhir:nullFlavor [ fhir:v "NI" ] ;
          ( fhir:templateId [
fhir:root [ fhir:v "1.3.6.1.4.1.19376.1.5.3.1.3.18" ]           ] ) ;
fhir:code [
fhir:code [ fhir:v "10187-3" ] ;
fhir:codeSystem [ fhir:v "2.16.840.1.113883.6.1" ] ;
fhir:codeSystemName [ fhir:v "LOINC" ] ;
fhir:displayName [ fhir:v "Review of systems Narrative - Reported" ]           ] ;
fhir:title [
fhir:xmlText [ fhir:v "Review of Systems" ]           ] ;
fhir:text "<div xmlns=\"http://www.w3.org/1999/xhtml\">No information</div>"         ]       ] )     ] #  All sections are set to nullFlavor \/ text = No information, \n        as this is a header example, not a complete body example 
  ] . #