FHIR Release 3 (STU) CI-Build

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0 . For a full list Continuous Integration Build of available versions, see FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Questionnaire-example-bluebook

Example Questionnaire/bb (Narrative)

Maturity Level : N/A
Responsible Owner: FHIR Infrastructure Work Group Ballot Standards Status : Informative Compartments : Not linked to any No defined compartments

This is the narrative for the resource. See also the XML or , JSON or Turtle format. This example conforms to the profile Questionnaire .

Name of child: ____________________________________ Sex: __ Neonatal Information Birth Weight (kg): ___________ Birth Length (cm): ___________ Vitamin K given : __ 1st dose: ___________ 2nd dose: ___________ Hep B given : __ Date given : ___________ Abnormalities noted at birth: _______________________________________________ 
        
        Birth details - To be completed by health professional
  Name of child: ____________________________________
            Sex: __
            
  Neonatal Information
    Birth Weight (kg): ___________
    Birth Length (cm): ___________
    Vitamin K given  : __
             1st dose: ___________
             2nd dose: ___________
    Hep B given      : __
      Date given     : ___________
    Abnormalities noted at birth:
      _______________________________________________

 

 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.