{
  "resourceType" : "Patient",
  "id" : "example-targeted-provenance",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"]
  },
  "extension" : [{
    "id" : "race",
    "extension" : [{
      "url" : "ombCategory",
      "valueCoding" : {
        "system" : "urn:oid:2.16.840.1.113883.6.238",
        "code" : "2106-3",
        "display" : "White"
      }
    },
    {
      "url" : "text",
      "valueString" : "Mixed"
    }],
    "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
  },
  {
    "id" : "ethnicity",
    "extension" : [{
      "url" : "ombCategory",
      "valueCoding" : {
        "system" : "urn:oid:2.16.840.1.113883.6.238",
        "code" : "2135-2",
        "display" : "Hispanic or Latino"
      }
    },
    {
      "url" : "text",
      "valueString" : "Hispanic or Latino"
    }],
    "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
  },
  {
    "id" : "birthsex",
    "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
    "valueCode" : "F"
  },
  {
    "id" : "genderIdentity",
    "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
        "code" : "UNK"
      }]
    }
  }],
  "identifier" : [{
    "system" : "http://hospital.smarthealthit.org",
    "value" : "1032702"
  }],
  "active" : true,
  "name" : [{
    "family" : "Shaw",
    "given" : ["Amy",
    "V."]
  }],
  "telecom" : [{
    "system" : "phone",
    "value" : "555-555-5555"
  }],
  "gender" : "female",
  "_gender" : {
    "id" : "gender"
  },
  "birthDate" : "1987-02-20",
  "address" : [{
    "line" : ["183 Mountain View St"],
    "city" : "Mounds",
    "state" : "OK"
  }]
}