{ "resourceType" : "Questionnaire", "id" : "QIMMZCRegisterClient", "meta" : { "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"] }, "language" : "en", "text" : { "status" : "generated", "div" : "
\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIdTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" Immunization - Client Registration QuestionnaireQuestionnairehttp://smart.who.int/ig/smart-immunizations/Questionnaire/QIMMZCRegisterClient#0.1.0
\".\"\".\"\".\" uniqueIdUnique identifier for the client1..1string
\".\"\".\"\".\" nameClient name1..1group
\".\"\".\"\".\"\".\" fullNameFull name of the client1..1string
\".\"\".\"\".\"\".\" firstNameFirst or given name0..1string
\".\"\".\"\".\"\".\" familyNameFamily name0..1string
\".\"\".\"\".\" sexSex1..1choiceValue Set: IMMZ.C.DE5 ValueSet for Sex
\".\"\".\"\".\" birthDateBirth Date0..1date
\".\"\".\"\".\" caregiverCare giver name1..1group
\".\"\".\"\".\"\".\" fullNameFull name of the care giver1..1string
\".\"\".\"\".\"\".\" firstNameFirst or given name0..1string
\".\"\".\"\".\"\".\" familyNameFamily name0..1string
\".\"\".\"\".\" phoneClient Phone number1..1string
\".\"\".\"\".\" administrativeAreaAdministrative area0..1choice
\".\"\".\"\".\" healthWorkerHealth Worker1..1boolean

\"doco\" Documentation for this format
" }, "contained" : [{ "resourceType" : "ValueSet", "id" : "IMMZ.C.DE5", "url" : "http://smart.who.int/ig/smart-immunizations/ValueSet/IMMZ.C.DE5", "name" : "IMMZ_C_DE5", "title" : "IMMZ.C.DE5 ValueSet for Sex", "status" : "active", "experimental" : false, "description" : "ValueSet for Sex for IMMZ.C.DE5.", "compose" : { "include" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "concept" : [{ "code" : "DE6", "display" : "Male" }, { "code" : "DE7", "display" : "Female" }, { "code" : "DE8", "display" : "Biological sex not specified" }, { "code" : "DE9", "display" : "Intersex" }] }] } }], "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap", "valueCanonical" : "http://smart.who.int/ig/smart-immunizations/StructureMap/IMMZCQRToPatient" }], "url" : "http://smart.who.int/ig/smart-immunizations/Questionnaire/QIMMZCRegisterClient", "version" : "0.1.0", "title" : "Client Registration Questionnaire", "status" : "draft", "subjectType" : ["Patient"], "date" : "2024-03-22T16:39:50+00:00", "publisher" : "World Health Organization (WHO)", "contact" : [{ "name" : "World Health Organization (WHO)", "telecom" : [{ "system" : "url", "value" : "https://www.who.int" }] }], "description" : "Immunization - Client Registration Questionnaire", "jurisdiction" : [{ "coding" : [{ "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm", "code" : "001" }] }], "item" : [{ "linkId" : "uniqueId", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE1" }], "text" : "Unique identifier for the client", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "name", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE2" }, { "system" : "http://loinc.org", "code" : "54125-0", "display" : "Patient name" }, { "system" : "http://snomed.info/sct", "code" : "371484003", "display" : "Patient name (observable entity)" }], "text" : "Client name", "type" : "group", "required" : true, "repeats" : false, "item" : [{ "linkId" : "fullName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE2" }, { "system" : "http://loinc.org", "code" : "54125-0", "display" : "Patient name" }, { "system" : "http://snomed.info/sct", "code" : "371484003", "display" : "Patient name (observable entity)" }], "text" : "Full name of the client", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "firstName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE3" }, { "system" : "http://loinc.org", "code" : "45392-8", "display" : "First name" }, { "system" : "http://snomed.info/sct", "code" : "184095009", "display" : "Patient forename (observable entity)" }], "text" : "First or given name", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "familyName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE4" }, { "system" : "http://loinc.org", "code" : "45394-4", "display" : "Last name" }, { "system" : "http://snomed.info/sct", "code" : "184096005", "display" : "Patient surname (observable entity)" }], "text" : "Family name", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "sex", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE5" }, { "system" : "http://loinc.org", "code" : "46098-0", "display" : "Sex" }, { "system" : "http://snomed.info/sct", "code" : "184100006", "display" : "Patient sex (observable entity)" }], "text" : "Sex", "type" : "choice", "required" : true, "repeats" : false, "answerValueSet" : "#IMMZ.C.DE5" }, { "linkId" : "birthDate", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE10" }, { "system" : "http://loinc.org", "code" : "21112-8", "display" : "Birth date" }, { "system" : "http://snomed.info/sct", "code" : "184099003", "display" : "Date of birth (observable entity)" }], "text" : "Birth Date", "type" : "date", "required" : false, "repeats" : false }, { "linkId" : "caregiver", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE14" }, { "system" : "http://snomed.info/sct", "code" : "184140000", "display" : "Caregiver details (observable entity)" }], "text" : "Care giver name", "type" : "group", "required" : true, "repeats" : false, "item" : [{ "linkId" : "fullName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE15" }, { "system" : "http://snomed.info/sct", "code" : "184140000", "display" : "Caregiver details (observable entity)" }], "text" : "Full name of the care giver", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "firstName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE16" }], "text" : "First or given name", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "familyName", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE17" }], "text" : "Family name", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "phone", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE18" }, { "system" : "http://loinc.org", "code" : "42077-8", "display" : "Patient Phone number" }, { "system" : "http://snomed.info/sct", "code" : "184103008", "display" : "Patient telephone number (observable entity)" }], "text" : "Client Phone number", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "administrativeArea", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE19" }, { "system" : "http://loinc.org", "code" : "56799-0", "display" : "Address" }, { "system" : "http://snomed.info/sct", "code" : "184097001", "display" : "Patient address (observable entity)" }], "text" : "Administrative area", "type" : "choice", "required" : false, "repeats" : false }, { "linkId" : "healthWorker", "code" : [{ "system" : "http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.C", "code" : "DE20" }], "text" : "Health Worker", "type" : "boolean", "required" : true, "repeats" : false }] }