{
  "resourceType": "Patient",
  "id": "SampleICSRPatient",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-icsr-patient"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>MilitaryStatus</b>: <span title=\"Codes: {http://ncimeta.nci.nih.gov C114854}\">C114854</span></p><p><b>identifier</b>: id: 123456789</p><p><b>name</b>: Irma Black </p><p><b>telecom</b>: <a href=\"tel:+1-234-653-6558\">+ 1-234-653-6558</a></p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1998-08-31</p><p><b>address</b>: 50878 Coleman Ferry Montague MA US </p></div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-icsr-ext-militarystatus",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://ncimeta.nci.nih.gov",
            "code": "C114854"
          }
        ]
      }
    }
  ],
  "identifier": [
    {
      "system": "http://hl7.org/fhir/sid/us-ssn",
      "value": "123456789"
    }
  ],
  "name": [
    {
      "family": "Black",
      "given": [
        "Irma"
      ]
    }
  ],
  "telecom": [
    {
      "system": "phone",
      "value": "+ 1-234-653-6558"
    }
  ],
  "gender": "female",
  "birthDate": "1998-08-31",
  "address": [
    {
      "line": [
        "50878 Coleman Ferry"
      ],
      "city": "Montague",
      "state": "MA",
      "country": "US"
    }
  ]
}