Real-world lifelines questionnaire (fictively taken from the patient) (id = "f201")

<?xml version="1.0" encoding="UTF-8"?>


  
  
    
    
      Lifelines Questionnaire 1 part 1
  1. Do you have allergies?
  2. General Questions:
    2.a) What is your gender?
    2.b) What is your date of birth?
    2.c) What is your country of birth?
    2.d) What is your marital status?
    3. Intoxications:
      3.a) Do you smoke?
      3.b) Do you drink alcohol?
    
  
  
  
  
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
    
      
      
      
    
    
      
      
      
    
    
      
      
      
    
    
      
      
      
    
  
  
    
    
    
    
      
      
      
    
    
      
      
      
    
  

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="f201"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      
      <pre> Lifelines Questionnaire 1 part 1
  1. Do you have allergies?
  2. General Questions:
    2.a) What is your gender?
    2.b) What is your date of birth?
    2.c) What is your country of birth?
    2.d) What is your marital status?
    3. Intoxications:
      3.a) Do you smoke?
      3.b) Do you drink alcohol?</pre> 
    
    </div>   </text>   <url value="http://hl7.org/fhir/Questionnaire/f201"/>   <identifier>     <system value="urn:ietf:rfc:3986"/>     <value value="urn:oid:2.16.840.1.113883.4.642.20.6"/>   </identifier>   <status value="active"/>   <subjectType value="Patient"/>   <date value="2010"/>   <code>     <system value="http://example.org/system/code/lifelines/nl"/>     <code value="VL 1-1, 18-65_1.2.2"/>     <display value="Lifelines Questionnaire 1 part 1"/>   </code>   <item>     <linkId value="1"/>     <text value="Do you have allergies?"/>     <type value="boolean"/>   </item>   <item>     <linkId value="2"/>     <text value="General questions"/>     <type value="group"/>     <item>       <linkId value="2.1"/>       <text value="What is your gender?"/>       <type value="string"/>     </item>     <item>       <linkId value="2.2"/>       <text value="What is your date of birth?"/>       <type value="date"/>     </item>     <item>       <linkId value="2.3"/>       <text value="What is your country of birth?"/>       <type value="string"/>     </item>     <item>       <linkId value="2.4"/>       <text value="What is your marital status?"/>       <type value="string"/>     </item>   </item>   <item>     <linkId value="3"/>     <text value="Intoxications"/>     <type value="group"/>     <item>       <linkId value="3.1"/>       <text value="Do you smoke?"/>       <type value="boolean"/>     </item>     <item>       <linkId value="3.2"/>       <text value="Do you drink alchohol?"/>       <type value="boolean"/>     </item>   </item> 


</

Questionnaire

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