{ "resourceType" : "Questionnaire", "id" : "QIMMZC4", "meta" : { "profile" : ["http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"] }, "language" : "en", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire QIMMZC4

Language: en

Profile: Extractable Questionnaire - StructureMap

\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\"
\".\"\".\" Questionnaire for IMMZ.C4.Create client recordQuestionnairehttp://smart.who.int/immunizations/Questionnaire/QIMMZC4#1.0.0
\".\"\".\"\".\" uniqueIdentifierUnique identifier1..1string
\".\"\".\"\".\" nameName1..1string
\".\"\".\"\".\" firstNameFirst name0..1string
\".\"\".\"\".\" familyNameFamily name0..1string
\".\"\".\"\".\" sexSex1..1choiceValue Set: IMMZ.C.DE5 ValueSet for Sex
\".\"\".\"\".\" dateOfBirthDate of birth1..1date
\".\"\".\"\".\" ageAge0..1string
\".\"\".\"\".\" caregiversMultipleCaregivers (multiple)0..*group
\".\"\".\"\".\"\".\" caregiversFullNameCaregiver's full name0..1string
\".\"\".\"\".\"\".\" caregiversFirstNameCaregiver's first name0..1string
\".\"\".\"\".\"\".\" caregiversFamilyNameCaregiver's family name0..1string
\".\"\".\"\".\" contactPhoneNumberContact phone number1..1string
\".\"\".\"\".\" addressAddress1..1string

\"doco\" Documentation for this format

Contained Resources

ValueSet #IMMZ.C.DE5

This value set expansion contains 4 concepts.

SystemCodeDisplayDefinition
http://smart.who.int/immunizations/CodeSystem/IMMZ.C\u00a0\u00a0DE6MaleClient's biological sex is male
http://smart.who.int/immunizations/CodeSystem/IMMZ.C\u00a0\u00a0DE7FemaleClient's biological sex is female
http://smart.who.int/immunizations/CodeSystem/IMMZ.C\u00a0\u00a0DE8Biological sex not specifiedClient's biological sex is not specified
http://smart.who.int/immunizations/CodeSystem/IMMZ.C\u00a0\u00a0DE9IntersexClient's biological sex is intersex
" }, "contained" : [{ "resourceType" : "ValueSet", "id" : "IMMZ.C.DE5", "url" : "http://smart.who.int/immunizations/ValueSet/IMMZ.C.DE5", "name" : "IMMZ_C_DE5", "title" : "IMMZ.C.DE5 ValueSet for Sex", "status" : "active", "description" : "ValueSet for Sex for IMMZ.C.DE5", "compose" : { "include" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "concept" : [{ "code" : "DE6", "display" : "Male" }, { "code" : "DE7", "display" : "Female" }, { "code" : "DE8", "display" : "Biological sex not specified" }, { "code" : "DE9", "display" : "Intersex" }] }] }, "expansion" : { "timestamp" : "2025-06-25T16:39:07.092Z", "contains" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE6", "display" : "Male" }, { "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE7", "display" : "Female" }, { "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE8", "display" : "Biological sex not specified" }, { "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE9", "display" : "Intersex" }] } }], "extension" : [{ "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap", "valueCanonical" : "http://smart.who.int/immunizations/StructureMap/IMMZ.C4.QRToPatient" }], "url" : "http://smart.who.int/immunizations/Questionnaire/QIMMZC4", "version" : "1.0.0", "title" : "IMMZ.C4.Create client record", "status" : "draft", "subjectType" : ["Patient"], "date" : "2026-03-31T13:54:17+00:00", "publisher" : "WHO", "contact" : [{ "name" : "WHO", "telecom" : [{ "system" : "url", "value" : "http://who.int" }] }], "description" : "Questionnaire for IMMZ.C4.Create client record", "item" : [{ "linkId" : "uniqueIdentifier", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE1" }], "text" : "Unique identifier", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "name", "code" : [{ "system" : "http://smart.who.int/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" : "Name", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "firstName", "code" : [{ "system" : "http://smart.who.int/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 name", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "familyName", "code" : [{ "system" : "http://smart.who.int/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/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" : "dateOfBirth", "code" : [{ "system" : "http://smart.who.int/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" : "Date of birth", "type" : "date", "required" : true, "repeats" : false }, { "linkId" : "age", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE13" }, { "system" : "http://loinc.org", "code" : "63900-5", "display" : "Current age or age at death" }], "text" : "Age", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "caregiversMultiple", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE14" }, { "system" : "http://snomed.info/sct", "code" : "184140000", "display" : "Caregiver details (observable entity)" }], "text" : "Caregivers (multiple)", "type" : "group", "required" : false, "repeats" : true, "item" : [{ "linkId" : "caregiversFullName", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE15" }, { "system" : "http://snomed.info/sct", "code" : "184140000", "display" : "Caregiver details (observable entity)" }], "text" : "Caregiver's full name", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "caregiversFirstName", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE16" }, { "system" : "http://loinc.org", "code" : "45392-8", "display" : "First name" }], "text" : "Caregiver's first name", "type" : "string", "required" : false, "repeats" : false }, { "linkId" : "caregiversFamilyName", "code" : [{ "system" : "http://smart.who.int/immunizations/CodeSystem/IMMZ.C", "code" : "DE17" }, { "system" : "http://loinc.org", "code" : "45394-4", "display" : "Last name" }], "text" : "Caregiver's family name", "type" : "string", "required" : false, "repeats" : false }] }, { "linkId" : "contactPhoneNumber", "code" : [{ "system" : "http://smart.who.int/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" : "Contact phone number", "type" : "string", "required" : true, "repeats" : false }, { "linkId" : "address", "code" : [{ "system" : "http://smart.who.int/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" : "Address", "type" : "string", "required" : true, "repeats" : false }] }