<Patient xmlns="http://hl7.org/fhir">
  <meta>
    <profile value="https://example.org/fhir/StructureDefinition/Patient" />
  </meta>
  <extension url="https://example.org/fhir/StructureDefinition/Headoffamily">
    <valueHumanName>
      <text value="Wahyu Yulianto" />
    </valueHumanName>
  </extension>
  <extension url="https://example.org/fhir/StructureDefinition/HeadFamilyRelation">
    <valueCodeableConcept>
      <coding>
        <code value="husb" />
        <display value="Husband" />
      </coding>
      <text value="Suami" />
    </valueCodeableConcept>
  </extension>
  <extension url="https://example.org/fhir/StructureDefinition/HeadOfFamilyID">
    <valueIdentifier>
      <use value="official" />
      <type>
        <coding>
          <code value="KTP" />
          <display value="Nomor Kartu Tanda Penduduk" />
        </coding>
      </type>
      <value value="3318125206870000" />
    </valueIdentifier>
  </extension>
  <extension url="https://example.org/fhir/StructureDefinition/BirthPlace">
    <valueAddress>
      <district value="Kulon Progo" />
    </valueAddress>
  </extension>
  <extension url="http://example.org/fhir/StructureDefinition/Age">
    <valueAge>
      <value value="27" />
    </valueAge>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/patient-religion">
    <valueCodeableConcept>
      <coding>
        <code value="1" />
        <display value="Islam" />
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="http://example.org/fhir/StructureDefinition/Education">
    <valueCodeableConcept>
      <coding>
        <code value="6" />
        <display value="S1" />
      </coding>
      <text value="Sarjana" />
    </valueCodeableConcept>
  </extension>
  <extension url="https://example.org/fhir/StructureDefinition/Citizenship">
    <valueCodeableConcept>
      <coding>
        <code value="1" />
        <display value="WNI" />
      </coding>
      <text value="WNI" />
    </valueCodeableConcept>
  </extension>
  <extension url="http://example.org/fhir/StructureDefinition/Profession">
    <valueCodeableConcept>
      <coding>
        <code value="12" />
        <display value="Industri" />
      </coding>
      <text value="Karyawan Industri" />
    </valueCodeableConcept>
  </extension>
  <extension url="https://example.org/fhir/StructureDefinition/Extension-BloodType">
    <valueCodeableConcept>
      <coding>
        <code value="2" />
        <display value="B" />
      </coding>
    </valueCodeableConcept>
  </extension>
  <identifier>
    <use value="official" />
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
        <code value="MR" />
        <display value="Medical Record Number" />
      </coding>
    </type>
    <system value="http://coders_P3401120202.com" />
    <value value="87654321" />
  </identifier>
  <identifier>
    <use value="official" />
    <type>
      <coding>
        <code value="KK" />
        <display value="Nomor Kartu Keluarga" />
      </coding>
    </type>
    <value value="3318125206870001" />
  </identifier>
  <identifier>
    <use value="official" />
    <type>
      <coding>
        <code value="KTP" />
        <display value="Nomor Kartu Tanda Penduduk" />
      </coding>
    </type>
    <value value="3318205210940000" />
  </identifier>
  <identifier>
    <use value="official" />
    <type>
      <coding>
        <code value="RM" />
        <display value="Nomor Rekam Medis" />
      </coding>
    </type>
    <value value="00112233" />
  </identifier>
  <name>
    <use value="official" />
    <text value="Rida Sita" />
  </name>
  <telecom>
    <system value="phone" />
    <value value="(0274) 555111" />
    <use value="home" />
  </telecom>
  <telecom>
    <system value="phone" />
    <value value="081123456789" />
    <use value="mobile" />
  </telecom>
  <telecom>
    <system value="email" />
    <value value="ridasita@gmail.com" />
    <use value="work" />
  </telecom>
  <gender value="female" />
  <birthDate value="1994-10-20" />
  <address>
    <use value="home" />
    <type value="both" />
    <line value="Jalan Anggrek No 08" />
    <city value="Kulon Progo" />
    <postalCode value="55653" />
  </address>
  <address>
    <extension url="http://example.org/fhir/StructureDefinition/AddressVillage">
      <valueCodeableConcept>
        <coding>
          <code value="2001" />
          <display value="Kebonharjo" />
        </coding>
        <text value="Kelurahan Kebonharjo" />
      </valueCodeableConcept>
    </extension>
    <extension url="http://example.org/fhir/StructureDefinition/District">
      <valueCodeableConcept>
        <coding>
          <code value="11" />
          <display value="Samigaluh" />
        </coding>
        <text value="Kecamatan Samigaluh" />
      </valueCodeableConcept>
    </extension>
    <extension url="http://example.org/fhir/StructureDefinition/Province">
      <valueCodeableConcept>
        <coding>
          <code value="34" />
          <display value="DIY" />
        </coding>
        <text value="Provinsi DIY" />
      </valueCodeableConcept>
    </extension>
  </address>
  <maritalStatus>
    <coding>
      <code value="M" />
      <display value="Married" />
    </coding>
  </maritalStatus>
  <photo>
    <url value="http://" />
  </photo>
  <contact>
    <relationship>
      <coding>
        <code value="N" />
        <display value="Next-of-Kin" />
      </coding>
      <text value="Suami pasien" />
    </relationship>
    <name>
      <use value="official" />
      <text value="Rizal Akbar" />
    </name>
    <telecom>
      <system value="phone" />
      <value value="081233679654" />
      <use value="mobile" />
    </telecom>
    <address>
      <extension url="http://example.org/fhir/StructureDefinition/ContactVillage">
        <valueCodeableConcept>
          <coding>
            <code value="2001" />
            <display value="Kebonharjo" />
          </coding>
          <text value="Kelurahan Kebonharjo" />
        </valueCodeableConcept>
      </extension>
      <extension url="http://example.org/fhir/StructureDefinition/ContactDistrict">
        <valueCodeableConcept>
          <coding>
            <code value="11" />
            <display value="Samigaluh" />
          </coding>
          <text value="Kecamatan Samigaluh" />
        </valueCodeableConcept>
      </extension>
      <extension url="http://example.org/fhir/StructureDefinition/ContactProvince">
        <valueCodeableConcept>
          <coding>
            <code value="34" />
            <display value="DIY" />
          </coding>
          <text value="Provinsi DIY" />
        </valueCodeableConcept>
      </extension>
      <use value="home" />
      <line value="Jalan Anggrek No 08" />
      <city value="Kulon Progo" />
      <postalCode value="64416" />
    </address>
    <gender value="male" />
  </contact>
  <managingOrganization>
    <reference value="Organization/2581128" />
    <identifier>
      <use value="official" />
      <type>
        <coding>
          <code value="edu" />
          <display value="institusi pendidikan" />
        </coding>
      </type>
      <value value="SMA Negeri 1 Kalibawang" />
    </identifier>
    <name value="SMA Negeri 1 Kalibawang" />
    <telecom>
      <system value="phone" />
      <use value="mobile" />
      <value value="08887100089" />
    </telecom>
    <telecom>
      <system value="phone" />
      <use value="work" />
      <value value="(0274) 868312" />
    </telecom>
    <address>
      <use value="home" />
      <line value="Jl. Dekso-Samigaluh No.KM 1, Kriyan, Banjararum, Kec. Kalibawang" />
      <city value="Kulon Progo" />
      <postalCode value="55672" />
    </address>
  </managingOrganization>
</Patient>