cda/plugins/org.eclipse.mdht.uml.cda/samples/Sample_CCDA_CCD_b1_Ambulatory_v2.xml

<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="CDA.xsl"?>
<!--
	Title: US_Realm_Header_Template

	Revision History:
	 01/31/2011 bam created
    07/29/2011 RWM modified
    11/26/2011 RWM modified
    08/12/2012 RWM modified
    09/12/2012 BNR(Dragon) modified

 -->
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
 xsi:schemaLocation="urn:hl7-org:v3 ../../../CDA%20R2/cda-schemas-and-samples/infrastructure/cda/CDA.xsd"
 xmlns="urn:hl7-org:v3"
 xmlns:cda="urn:hl7-org:v3"
 xmlns:sdtc="urn:hl7-org:sdtc">
   
   <!--
********************************************************
  CDA Header
********************************************************
	-->
   <!-- CONF 16791 -->
   <realmCode
      code="US"/>
   
   <!-- CONF 5361 -->
   <typeId
      root="2.16.840.1.113883.1.3"
      extension="POCD_HD000040"/>
   
   <!-- US General Header Template -->
   <!-- CONF 5252 -->
   <templateId
      root="2.16.840.1.113883.10.20.22.1.1"/>
   <!-- *** Note:  The next templateId, code and title will differ depending on what type of document is being sent. *** -->
   <!-- conforms to the document specific requirements  -->
   <templateId
      root="2.16.840.1.113883.10.20.22.1.2"/>
   
   <!-- CONF 5363 -->
   <id
      extension="Test CCDA"
      root="1.1.1.1.1.1.1.1.1"/>
   
   <!-- CONF 5253 "CCD document" -->
   <code
      codeSystem="2.16.840.1.113883.6.1"
      codeSystemName="LOINC"
      code="34133-9"
      displayName="Summarization of Episode Note"/>
   
   <!-- CONF 5254 -->
   <title>Community Health and Hospitals: Health Summary</title>
   
   <!-- CONF 5256 -->
   <effectiveTime
      value="20120912000000-0000"/>
   
   <!-- 5259 -->
   <confidentialityCode
      code="N"
      codeSystem="2.16.840.1.113883.5.25"/>
   
   <!-- 5372 -->
   <languageCode
      code="en-US"/>
   
   <!-- CONF 5266 -->
   <recordTarget>
      
      <!-- CONF 5267 -->
      <patientRole>
         
         <!-- CONF 5268-->
         <id
            extension="1"
            root="2.16.840.1.113883.4.6"/>
         <!-- Fake ID using HL7 example OID. -->
         
         <!-- Patient SSN recorded as an ID -->
         <id
            extension="123-101-5230"
            root="2.16.840.1.113883.4.1"/>
         
         <!-- CONF 5271 -->
         <addr
            use="HP">
            <!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
            <streetAddressLine>1357 Amber Drive</streetAddressLine>
            <city>Beaverton</city>
            <state>OR</state>
            <postalCode>97006</postalCode>
            <country>US</country>
            <!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
         </addr>
         
         <!-- CONF 5280 -->
         <telecom
            value="tel:(816)276-6909"
            use="HP">foobar</telecom>
         <!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
         
         <!-- CONF 5283 -->
         <patient>
            
            <!-- CONF 5284 -->
            <name
               use="L">
               <!-- L is "Legal" from HL7 EntityNameUse 2.16.840.1.113883.5.45 -->
               <given>Myra</given>
               <!-- CL is "Call me" from HL7 EntityNamePartQualifier 2.16.840.1.113883.5.43 -->
               <family>Jones</family>
            </name>
            <administrativeGenderCode
               code="F"
               codeSystem="2.16.840.1.113883.5.1"
               displayName="Female"/>
            <birthTime
               value="19470501"/>
            
            <maritalStatusCode
               code="M"
               displayName="Married"
               codeSystem="2.16.840.1.113883.5.2"
               codeSystemName="MaritalStatusCode"/>
            <religiousAffiliationCode
               code="1013"
               displayName="Christian (non-Catholic, non-specific)"
               codeSystemName="HL7 Religious Affiliation "
               codeSystem="2.16.840.1.113883.5.1076"/>
            
            <!-- Need to Fix the Race Code to be from the OMB Standards -->
            <raceCode
               code="2106-3"
               displayName="White"
               codeSystem="2.16.840.1.113883.6.238"
               codeSystemName="Race and Ethnicity - CDC"/>
            <ethnicGroupCode
               code="2186-5"
               displayName="Not Hispanic or Latino"
               codeSystem="2.16.840.1.113883.6.238"
               codeSystemName="Race and Ethnicity - CDC"/>
                 
            <guardian>
               <code
                  code="GPARNT"
                  displayName="Grandfather"
                  codeSystem="2.16.840.1.113883.5.111"
                  codeSystemName="HL7 Role code"/>
               <addr
                  use="HP">
                  <!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
                  <streetAddressLine>1357 Amber Drive</streetAddressLine>
                  <city>Beaverton</city>
                  <state>OR</state>
                  <postalCode>97006</postalCode>
                  <country>US</country>
                  <!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
               </addr>
               <telecom
                  value="tel:(816)276-6909"
                  use="HP"/>
               <guardianPerson>
                  <name>
                     <given>Ralph</given>
                     <family>Jones</family>
                  </name>
               </guardianPerson>
            </guardian>
            <birthplace>
               <place>
                  <addr>
                     <city>Beaverton</city>
                     <state>OR</state>
                     <postalCode>97006</postalCode>
                     <country>US</country>
                  </addr>
               </place>
            </birthplace>
            
            <!-- FIX  the Code System to be 639.2 -->
            <languageCommunication>
               <languageCode
                  code="eng"/>
               <modeCode
                  code="ESP"
                  displayName="Expressed spoken"
                  codeSystem="2.16.840.1.113883.5.60"
                  codeSystemName="LanguageAbilityMode"/>
               <preferenceInd
                  value="true"/>
            </languageCommunication>
         </patient>
         <providerOrganization>
            <id
               root="1.1.1.1.1.1.1.1.4"/>
            <name>Community Health and Hospitals</name>
            <telecom
               use="WP"
               value="tel: 555-555-5000"/>
            <addr>
               <streetAddressLine>1002 Healthcare Dr</streetAddressLine>
               <city>Portland</city>
               <state>OR</state>
               <postalCode>97266</postalCode>
               <country>US</country>
            </addr>
         </providerOrganization>
      </patientRole>
   </recordTarget>
</ClinicalDocument>