<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="anc-quick-check" />
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <b>Structure</b>
      <table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;">
        <tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top">
          <th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkId for the item">LinkId</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the itemcan appear in the instance">Cardinality</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a>
          </th>
          <th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a>
            <span style="float: right">
              <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
                <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" />
              </a>
            </span>
          </th>
        </tr>
        <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white">
          <td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy" /> ANC_Quick_Check</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">A sample questionnaire using itemMedia and itemAnswerMedia extensions</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td>
          <td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check#3.0.0</td>
        </tr>
        <tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7">
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" id="item.reason-for-visit" class="hierarchy">
            <img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy" />
            <img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy" /> reason-for-visit</td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Why did you come?</td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">
            <a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a>
          </td>
          <td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item.reason-for-visit">5 options</a></td>
        </tr>
        <tr>
          <td colspan="5" class="hierarchy">
            <br />
            <a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format">
              <img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit" /> Documentation for this format</a>
          </td>
        </tr>
      </table>
      <hr />
      <p>
        <b>Option Sets</b>
      </p>
      <a name="opt-item.reason-for-visit"></a>
      <p>
        <b>Answer options for reason-for-visit</b>
      </p>
      <ul>
        <li style="font-size: 11px">For a scheduled (routine) visit</li>
        <li style="font-size: 11px">For specific complaints about you or your baby</li>
        <li style="font-size: 11px">First visit</li>
        <li style="font-size: 11px">Follow-up visit</li>
        <li style="font-size: 11px">Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?</li>
      </ul>
    </div>
  </text>
  <url value="http://hl7.org/fhir/uv/sdc/Questionnaire/anc-quick-check" />
  <version value="3.0.0" />
  <name value="ANC_Quick_Check" />
  <title value="Questionnaire - ANC Quick Check" />
  <status value="draft" />
  <experimental value="true" />
  <subjectType value="Patient" />
  <date value="2022-03-08T18:33:14+00:00" />
  <publisher value="HL7 International - FHIR Infrastructure Work Group" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://hl7.org/Special/committees/fiwg" />
    </telecom>
  </contact>
  <description value="A sample questionnaire using itemMedia and itemAnswerMedia extensions" />
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm" />
      <code value="001" />
    </coding>
  </jurisdiction>
  <item>
    <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemMedia">
      <valueAttachment>
        <url value="http://example.org/images/reason-for-visit.png" />
      </valueAttachment>
    </extension>
    <linkId value="reason-for-visit" />
    <text value="Why did you come?" />
    <type value="choice" />
    <answerOption>
      <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia">
        <valueAttachment>
          <url value="http://example.org/images/reason-for-visit-routine.png" />
        </valueAttachment>
      </extension>
      <valueString value="For a scheduled (routine) visit" />
    </answerOption>
    <answerOption>
      <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia">
        <valueAttachment>
          <url value="http://example.org/images/reason-for-visit-specific-complaint.png" />
        </valueAttachment>
      </extension>
      <valueString value="For specific complaints about you or your baby" />
    </answerOption>
    <answerOption>
      <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia">
        <valueAttachment>
          <url value="http://example.org/images/reason-for-visit-first.png" />
        </valueAttachment>
      </extension>
      <valueString value="First visit" />
    </answerOption>
    <answerOption>
      <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia">
        <valueAttachment>
          <url value="http://example.org/images/reason-for-visit-follow-up.png" />
        </valueAttachment>
      </extension>
      <valueString value="Follow-up visit" />
    </answerOption>
    <answerOption>
      <extension url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemAnswerMedia">
        <valueAttachment>
          <url value="http://example.org/images/reason-for-visit-include-family-member.png" />
        </valueAttachment>
      </extension>
      <valueString value="Do you want to include your companion or other family member (parent if adolescent) in the examination and discussion?" />
    </answerOption>
  </item>
</Questionnaire>