This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v1.1.0: STU1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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: US Core Patient Example - XML Representation

Page standards status: Informative

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<Patient xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
      <valueString value="Patient Example"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/instance-description">
      <valueMarkdown
                     value="This is a patient example for the *US Core Patient Profile*."/>
    </extension>
    <profile
             value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Amy V. Baxter </b> female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (USUAL))</p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2106-3"/>
        <display value="White"/>
      </valueCoding>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1002-5"/>
        <display value="American Indian or Alaska Native"/>
      </valueCoding>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2028-9"/>
        <display value="Asian"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1586-7"/>
        <display value="Shoshone"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2036-2"/>
        <display value="Filipino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Mixed"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2135-2"/>
        <display value="Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2184-0"/>
        <display value="Dominican"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2148-5"/>
        <display value="Mexican"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity">
    <valueCodeableConcept>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
        <code value="ASKU"/>
        <display value="asked but unknown"/>
      </coding>
      <text value="asked but unknown"/>
    </valueCodeableConcept>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
      <text value="Medical Record Number"/>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <active value="true"/>
  <name>
    <use value="old"/>
    <family value="Shaw"/>
    <given value="Amy"/>
    <given value="V."/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </name>
  <name>
    <family value="Baxter"/>
    <given value="Amy"/>
    <given value="V."/>
    <suffix value="PharmD"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="555-555-5555"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="amy.shaw@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="1987-02-20"/>
  <address>
    <use value="old"/>
    <line value="49 Meadow St"/>
    <city value="Alstead"/>
    <state value="NH"/>
    <postalCode value="03602"/>
    <country value="US"/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </address>
  <address>
    <line value="183 Mountain View St"/>
    <city value="Alstead"/>
    <state value="NH"/>
    <postalCode value="03602"/>
    <country value="US"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </address>
</Patient>