<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="05ED7277-BD41-44EE-B017-9502C3511844" />
  <meta>
    <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest|1.1.0" />
  </meta>
  <extension url="http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options">
    <valueCodeableConcept>
      <coding>
        <system value="http://ehealthontario.ca/fhir/CodeSystem/ereferral-source-types" />
        <code value="IRH" />
        <display value="Referral Source Type - Hospital Inpatient" />
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="http://ehealthontario.ca/fhir/StructureDefinition/ext-patient-present-location">
    <valueReference>
      <reference value="urn:uuid:25470f9e-0092-4997-af53-aa3ef0f50879" />
      <display value="Given the referral source this should probably be a hospital" />
    </valueReference>
  </extension>
  <identifier>
    <system value="http://www.rmssource.org/identifiers/ServiceRequest" />
    <value value="24A332A0-D399-40AF-A88E-26604B7BA0FF" />
  </identifier>
  <status value="active" />
  <intent value="proposal" />
  <category>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="424008009" />
      <display value="Nursing care surveillance" />
    </coding>
  </category>
  <priority value="routine" />
  <code>
    <coding>
      <system value="http://snomed.info/sct" />
      <code value="105385000" />
      <display value="Full-time nursing care at home by private nurse" />
    </coding>
  </code>
  <subject>
    <reference value="urn:uuid:7f7ad826-f47b-4c18-9d4a-bd3d0988ad3b" />
  </subject>
  <authoredOn value="2020-10-09" />
  <requester>
    <reference value="urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8" />
  </requester>
  <performer>
    <reference value="http://rmstarget.org/fhir/HealthcareService/16770" />
  </performer>
  <supportingInfo>
    <reference value="urn:uuid:f62038b6-0ce0-11ed-861d-0242ac120002" />
  </supportingInfo>
  <supportingInfo>
    <reference value="urn:uuid:157f4864-0ce1-11ed-861d-0242ac120002" />
  </supportingInfo>
  <supportingInfo>
    <reference value="urn:uuid:ac09a07c-03a5-4e1b-b0f1-b09ed700d26d" />
  </supportingInfo>
  <supportingInfo>
    <reference value="urn:uuid:25fc7cad-b076-4090-a803-d53b2039e28d" />
  </supportingInfo>
  <supportingInfo>
    <reference value="urn:uuid:9cea3cb8-d24f-4be2-acbf-dbc6c3801493" />
  </supportingInfo>
</ServiceRequest>