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hl7 priv samples Questionnaire Questionnaire-bb.json
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priv/samples/Questionnaire/Questionnaire-bb.json

{"resourceType":"Questionnaire","id":"bb","text":{"status":"generated","div":"\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\n \n \u003cpre\u003e\n \n \u003cb\u003eBirth details - To be completed by health professional\u003c/b\u003e\n Name of child: ____________________________________\n Sex: __\n \n Neonatal Information\n Birth Weight (kg): ___________\n Birth Length (cm): ___________\n Vitamin K given : __\n 1st dose: ___________\n 2nd dose: ___________\n Hep B given : __\n Date given : ___________\n Abnormalities noted at birth:\n _______________________________________________\n \n \u003c/pre\u003e\n \n \u003c/div\u003e"},"url":"http://hl7.org/fhir/Questionnaire/bb","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.20.4"}],"name":"NSWGovernmentMyPersonalHealthRecord","title":"NSW Government My Personal Health Record","status":"draft","subjectType":["Patient"],"date":"2013-02-19","publisher":"New South Wales Department of Health","description":"NSW Government My Personal Health Record","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"AU"}]}],"item":[{"linkId":"birthDetails","text":"Birth details - To be completed by health professional","type":"group","item":[{"linkId":"group","type":"group","item":[{"linkId":"nameOfChild","text":"Name of child","type":"string"},{"linkId":"sex","text":"Sex","type":"coding","answerOption":[{"valueCoding":{"code":"F"}},{"valueCoding":{"code":"M"}}]}]},{"linkId":"neonatalInformation","text":"Neonatal Information","type":"group","item":[{"linkId":"birthWeight","text":"Birth weight (kg)","type":"decimal"},{"linkId":"birthLength","text":"Birth length (cm)","type":"decimal"},{"linkId":"vitaminKgiven","text":"Vitamin K given","type":"coding","answerOption":[{"valueCoding":{"code":"INJECTION"}},{"valueCoding":{"code":"INTRAVENOUS"}},{"valueCoding":{"code":"ORAL"}}],"item":[{"linkId":"vitaminKgivenDoses","type":"group","enableWhen":[{"question":"vitaminKgiven","operator":"exists","answerBoolean":true}],"item":[{"linkId":"vitaminKDose1","text":"1st dose","type":"dateTime"},{"linkId":"vitaminKDose2","text":"2nd dose","type":"dateTime"}]}]},{"linkId":"hepBgiven","text":"Hep B given y / n","type":"boolean","item":[{"linkId":"hepBgivenDate","text":"Date given","type":"date"}]},{"linkId":"abnormalitiesAtBirth","text":"Abnormalities noted at birth","type":"string"}]}]}]}