Release 4B 5 Ballot

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-ballot: R5 Ballot - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Questionnaireresponse-example-ussg-fht-answers

Example QuestionnaireResponse/ussg-fht-answers (Narrative)

FHIR Infrastructure Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

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

LinkId Text Definition Answer doco
. . ussg-fht-answers QuestionnaireResponse
. . . 0
. . . . 0.1 Date Done 2008-01-17
. . . 1 Your health information
. . . . 1.1
. . . . . 1.1.1 Name Annie Proband
. . . . . 1.1.2 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . 1.1.3 Date of Birth 1966-04-04
. . . . . 1.1.4 Were you born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 1.1.5 Were you adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 1.1.6 Are your parents related to each other in any way other than marriage? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 1.1.7 Height 63
. . . . . . 1.1.7.1
. . . . . . . 1.1.7.1.1 Units UCUM Unified Code for Units of Measure (UCUM) [in_i]: inches
. . . . . 1.1.8 Weight 127
. . . . . . 1.1.8.1
. . . . . . . 1.1.8.1.1 Units UCUM Unified Code for Units of Measure (UCUM) [lb_av]: pounds
. . . . . 1.1.9 Body mass index (BMI) [Ratio] 22.5
. . . . . 1.1.10 Race LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA4457-3: White
. . . . . 1.1.11 Ethnicity
. . . 2 Family member health information
. . . . 2.1
. . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10405-1: Daughter
. . . . . 2.1.1.2 Name Susan
. . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . 2.1.1.4.2
. . . . . . . 2.1.1.4.2.2 Age 17
. . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10415-0: Brother
. . . . . . 2.1.1.2 Name Brian
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 32
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10550-4: -- Other Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10397-0: 30-39
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10418-4: Sister
. . . . . . 2.1.1.2 Name Janet
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 36
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10536-3: -- Breast Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10397-0: 30-39
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10419-2: Nephew
. . . . . . 2.1.1.2 Name Ian
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 16
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10420-0: Niece
. . . . . . 2.1.1.2 Name Helen
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 15
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10416-8: Father
. . . . . . 2.1.1.2 Name Donald
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 52
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10425-9: Paternal Uncle
. . . . . . 2.1.1.2 Name Eric
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 56
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10421-8: Paternal Aunt
. . . . . . 2.1.1.2 Name Fiona
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 57
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10543-9: -- Skin Cancer
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10423-4: Paternal Grandfather
. . . . . . 2.1.1.2 Name Bob
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . . 2.1.1.4.1
. . . . . . . . 2.1.1.4.1.1 Cause of Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10537-1: -- Colon Cancer
. . . . . . . . 2.1.1.4.1.2 Age at Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10400-2: OVER 60
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10537-1: -- Colon Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10400-2: OVER 60
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10424-2: Paternal Grandmother
. . . . . . 2.1.1.2 Name Claire
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . . 2.1.1.4.1
. . . . . . . . 2.1.1.4.1.1 Cause of Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10589-2: -- Other/Unexpected
. . . . . . . . . 2.1.1.4.1.1.1 Please specify Lou Gehrigs
. . . . . . . . 2.1.1.4.1.2 Age at Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10400-2: OVER 60
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10417-6: Mother
. . . . . . 2.1.1.2 Name Harriet
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . . 2.1.1.4.1
. . . . . . . . 2.1.1.4.1.1 Cause of Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10539-7: -- Ovarian Cancer
. . . . . . . . 2.1.1.4.1.2 Age at Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10399-6: 50-59
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10539-7: -- Ovarian Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10398-8: 40-49
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10414-3: Maternal Uncle
. . . . . . 2.1.1.2 Name Rudy
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 60
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10410-1: Maternal Aunt
. . . . . . 2.1.1.2 Name Julie
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 57
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10412-7: Maternal Grandfather
. . . . . . 2.1.1.2 Name Ian
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA2-8: Male
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . . 2.1.1.4.1
. . . . . . . . 2.1.1.4.1.1 Cause of Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10558-7: -- Heart Attack
. . . . . . . . 2.1.1.4.1.2 Age at Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10400-2: OVER 60
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10413-5: Maternal Grandmother
. . . . . . 2.1.1.2 Name Gladys
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . . 2.1.1.4.1
. . . . . . . . 2.1.1.4.1.1 Cause of Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10571-0: -- Other/Unknown
. . . . . . . . 2.1.1.4.1.2 Age at Death LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10400-2: OVER 60
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10536-3: -- Breast Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10399-6: 50-59
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10564-5: -- Asthma
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10395-4: Childhood
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10411-9: Maternal Cousin
. . . . . . 2.1.1.2 Name Karren
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 30
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . 2.1.2 This family member's history of disease
. . . . . . 2.1.2.1 Disease or Condition LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10536-3: -- Breast Cancer
. . . . . . 2.1.2.2 Age at Diagnosis LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10397-0: 30-39
. . . . 2.1
. . . . . 2.1.1
. . . . . . 2.1.1.1 Relationship to you LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA10411-9: Maternal Cousin
. . . . . . 2.1.1.2 Name Mary
. . . . . . 2.1.1.3 Gender LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA3-6: Female
. . . . . . 2.1.1.4 Living? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA33-6: Yes
. . . . . . . 2.1.1.4.2
. . . . . . . . 2.1.1.4.2.2 Age 31
. . . . . . 2.1.1.5 Was this person born a twin? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No
. . . . . . 2.1.1.6 Was this person adopted? LOINC Logical Observation Identifiers, Names and Codes (LOINC) LA32-8: No

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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.