<Patient xmlns="http://hl7.org/fhir">
  <id value="Example-patient-address-de-basis" />
  <identifier>
    <type>
      <coding>
        <system value="http://fhir.de/CodeSystem/identifier-type-de-basis" />
        <code value="KVZ10" />
      </coding>
    </type>
    <system value="http://fhir.de/sid/gkv/kvid-10" />
    <value value="X234567890" />
  </identifier>
  <name>
    <use value="official" />
    <family value="Musterman Test">
      <extension url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
        <valueString value="Test" />
      </extension>
    </family>
    <given value="Martina" />
  </name>
  <birthDate value="1935-06-22" />
  <address>
    <type value="physical" />
    <line value="Musterstr. 1">
      <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber">
        <valueString value="1" />
      </extension>
      <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName">
        <valueString value="Musterstr." />
      </extension>
    </line>
    <city value="Köln" />
    <postalCode value="50823" />
    <country value="Deutschland">
      <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-codedString">
        <valueCoding>
          <system value="urn:iso:std:iso:3166" />
          <code value="DE" />
          <display value="Germany" />
        </valueCoding>
      </extension>
    </country>
  </address>
</Patient>