<Bundle xmlns="http://hl7.org/fhir">
  <id value="B2DA55E6-52B6-4A75-AA5E-30649380F29F" />
  <meta>
    <profile value="http://ehealthontario.ca/fhir/StructureDefinition/eReferralBundle|1.0.0" />
  </meta>
  <type value="message" />
  <timestamp value="2020-10-09T15:21:51.2112+00:00" />
  <entry>
    <fullUrl value="urn:uuid:0b4e6041-a064-4978-862c-113b4636e5c1" />
    <resource>
      <MessageHeader>
        <id value="80dcc16a-1e7d-4220-855f-ad60cce0e641" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-MessageHeader|1.0.1" />
        </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="DR" />
              <display value="Referral Source Type - Primary Care Provider" />
            </coding>
          </valueCodeableConcept>
        </extension>
        <eventCoding>
          <system value="https://ehealthontario.ca/fhir/CodeSystem/message-event-code" />
          <code value="notify-update-service-request" />
        </eventCoding>
        <destination>
          <name value="RMS Target" />
          <endpoint value="http://rmstarget.org/fhir/$process-message" />
        </destination>
        <author>
          <reference value="urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8" />
          <display value="Dr. Jack Jones" />
        </author>
        <source>
          <name value="RMS Source" />
          <software value="Software" />
          <version value="1.1.0" />
          <contact>
            <system value="email" />
            <value value="tech.support@rmssource.org" />
            <rank value="1" />
          </contact>
          <endpoint value="http://rmssource.org/fhir/$process-message" />
        </source>
        <reason>
          <text value="Response to RFI, pdf document attached" />
        </reason>
        <response>
          <identifier value="B543CD93-873B-40C3-9491-0AE7C64A8858" />
          <code value="ok" />
        </response>
        <focus>
          <reference value="urn:uuid:25bcfe91-d072-4e76-9cfd-263871df3988" />
        </focus>
        <focus>
          <reference value="urn:uuid:e96979b6-0d67-11ed-861d-0242ac120002" />
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:25bcfe91-d072-4e76-9cfd-263871df3988" />
    <resource>
      <ServiceRequest>
        <id value="05ed7277-bd41-44ee-b017-9502c3511844" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest|1.0.1" />
        </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="DR" />
              <display value="Referral Source Type - Primary Care Provider" />
            </coding>
          </valueCodeableConcept>
        </extension>
        <identifier>
          <system value="http://www.rmssource.org/identifiers/ServiceRequest" />
          <value value="request-for-assessment" />
        </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" />
          <display value="Dr Jack Jones" />
        </requester>
        <performer>
          <reference value="http://rmstarget.org/fhir/HealthcareService/16770" />
        </performer>
        <supportingInfo>
          <reference value="urn:uuid:9cea3cb8-d24f-4be2-acbf-dbc6c3801493" />
          <display value="Referral Form" />
        </supportingInfo>
        <supportingInfo>
          <reference value="urn:uuid:93584625-9dde-40b7-8313-9c00ac26cc93" />
          <display value="Referral Form" />
        </supportingInfo>
        <supportingInfo>
          <reference value="4e58bb9a-0fac-4815-a824-3d5a2ffab93c" />
          <display value="Patient Consent" />
        </supportingInfo>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:e96979b6-0d67-11ed-861d-0242ac120002" />
    <resource>
      <Task>
        <id value="e96979b6-0d67-11ed-861d-0242ac120002" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Task|1.0.1" />
        </meta>
        <basedOn>
          <reference value="urn:uuid:05ed7277-bd41-44ee-b017-9502c3511844" />
        </basedOn>
        <status value="requested" />
        <businessStatus>
          <coding>
            <system value="https://ehealthontario.ca/fhir/CodeSystem/task-business-status" />
            <code value="NW" />
            <display value="New" />
          </coding>
          <text value="New" />
        </businessStatus>
        <intent value="proposal" />
        <code>
          <coding>
            <system value="https://ehealthontario.ca/fhir/CodeSystem/task-code" />
            <code value="request-for-information-for-requester" />
          </coding>
          <text value="Request for information" />
        </code>
        <description value="More information is needed, please provide x." />
        <authoredOn value="2020-10-10T18:40:36Z" />
        <lastModified value="2020-10-10T18:40:36Z" />
      </Task>
    </resource>
  </entry>
  <entry id="4e58bb9a-0fac-4815-a824-3d5a2ffab93c" />
  <entry>
    <fullUrl value="urn:uuid:37e4d7f1-14e0-47e4-955a-04541ac62c45" />
    <resource>
      <Patient>
        <id value="7F7AD826-F47B-4C18-9D4A-BD3D0988AD3B" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient|1.0.1" />
        </meta>
        <identifier>
          <extension url="http://ehealthontario.ca/fhir/StructureDefinition/ext-id-health-card-version-code">
            <valueString value="EX" />
          </extension>
          <use value="official" />
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
              <code value="JHN" />
            </coding>
            <text value="Ontario, Canada Personal Health Number" />
          </type>
          <system value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn" />
          <value value="1234567890" />
        </identifier>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
              <code value="MR" />
            </coding>
            <text value="The Hospital" />
          </type>
          <system value="http://ehealthontario.ca/fhir/NamingSystem/id-example1-uri" />
          <value value="ABC12345" />
        </identifier>
        <active value="true" />
        <name>
          <family value="Doe" />
          <given value="Jane" />
        </name>
        <telecom>
          <system value="phone" />
          <value value="1 (555) 867 5309" />
          <rank value="1" />
        </telecom>
        <telecom>
          <system value="email" />
          <value value="janedoe@example.com" />
          <rank value="2" />
        </telecom>
        <gender value="female" />
        <birthDate value="1951-02-19" />
        <deceasedBoolean value="false" />
        <address>
          <use value="home" />
          <type value="physical" />
          <line value="123 Any Street" />
          <city value="Waterloo" />
          <state value="ON" />
          <postalCode value="N2L 3G1" />
        </address>
        <contact>
          <relationship>
            <coding>
              <system value="http://ehealthontario.ca/fhir/CodeSystem/patient-contact-relationship" />
              <code value="EC" />
              <display value="Emergency Contact" />
            </coding>
            <text value="Emergency Contact" />
          </relationship>
          <name>
            <family value="McContact" />
            <given value="David" />
          </name>
          <telecom>
            <system value="phone" />
            <value value="(555) 555 1212" />
            <rank value="1" />
          </telecom>
          <address>
            <line value="50 Another St." />
            <line value="Unit 2" />
            <city value="Waterloo" />
            <state value="ON" />
            <postalCode value="N2L 3G2" />
          </address>
        </contact>
        <communication>
          <language>
            <coding>
              <system value="urn:ietf:bcp:47" />
              <code value="en" />
              <display value="English" />
            </coding>
            <text value="english" />
          </language>
        </communication>
        <generalPractitioner>
          <reference value="urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8" />
        </generalPractitioner>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:cfc608fd-b2bf-4cfa-a2e0-4f1bf18f2d35" />
    <resource>
      <PractitionerRole>
        <id value="86fa8373-34c8-440d-9e8f-832c1a571da8" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-PractitionerRole|1.0.0" />
        </meta>
        <identifier>
          <use value="official" />
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
              <code value="RRI" />
            </coding>
          </type>
          <system value="http://ehealthontario.ca/fhir/NamingSystem/id-ppr-epid" />
          <value value="56442" />
        </identifier>
        <active value="true" />
        <practitioner>
          <reference value="urn:uuid:8b9f61af-55ce-4ade-9987-f40fe54cc79e" />
          <display value="Dr Jack Jones" />
        </practitioner>
        <organization>
          <reference value="urn:uuid:334ec4c8-7932-4620-86fe-d6b33b3fc7e4" />
          <display value="Primary Care Medical Clinics" />
        </organization>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/practitioner-role" />
            <code value="doctor" />
            <display value="Doctor" />
          </coding>
        </code>
        <specialty>
          <coding>
            <system value="https://fhir.infoway-inforoute.ca/CodeSystem/snomedctcaextension" />
            <code value="394802001" />
            <display value="General medicine" />
          </coding>
        </specialty>
        <location>
          <reference value="urn:uuid:25470f9e-0092-4997-af53-aa3ef0f50879" />
          <display value="279 Yonge St, Barrie, ON L4N 7T9" />
        </location>
        <telecom>
          <system value="phone" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="1" />
        </telecom>
        <telecom>
          <system value="fax" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="3" />
        </telecom>
        <telecom>
          <system value="email" />
          <value value="jack.jones@example.org" />
          <use value="work" />
          <rank value="2" />
        </telecom>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1fcf4f02-8374-4834-83b3-9f0aed444c2c" />
    <resource>
      <Practitioner>
        <id value="8b9f61af-55ce-4ade-9987-f40fe54cc79e" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Practitioner|1.0.0" />
        </meta>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203" />
              <code value="LN" />
            </coding>
            <text value="Ontario Medical License Number" />
          </type>
          <system value="http://infoway-inforoute.ca/fhir/NamingSystem/ca-on-license-physician" />
          <value value="111789" />
        </identifier>
        <name>
          <use value="official" />
          <family value="Jones" />
          <given value="Jack" />
        </name>
        <telecom>
          <system value="phone" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="1" />
        </telecom>
        <telecom>
          <system value="fax" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="1" />
        </telecom>
        <address>
          <use value="work" />
          <type value="physical" />
          <line value="279 Yonge St" />
          <city value="Barrie" />
          <state value="ON" />
          <postalCode value="M5B 1N8" />
          <country value="CAN" />
        </address>
        <gender value="male" />
        <birthDate value="1979-02-26" />
        <qualification>
          <code>
            <coding>
              <system value="https://fhir.infoway-inforoute.ca/CodeSystem/scptype" />
              <code value="MD" />
            </coding>
          </code>
        </qualification>
        <communication>
          <coding>
            <system value="urn:ietf:bcp:47" />
            <code value="en" />
            <display value="English" />
          </coding>
          <text value="English" />
        </communication>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:334ec4c8-7932-4620-86fe-d6b33b3fc7e4" />
    <resource>
      <Organization>
        <id value="334ec4c8-7932-4620-86fe-d6b33b3fc7e4" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Organization|1.0.0" />
        </meta>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/organization-type" />
            <code value="prov" />
            <display value="Healthcare Provider" />
          </coding>
        </type>
        <name value="Primary Care Medical Clinics" />
        <telecom>
          <system value="phone" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="1" />
        </telecom>
        <telecom>
          <system value="fax" />
          <value value="(555) 987-1234" />
          <use value="work" />
          <rank value="1" />
        </telecom>
        <address>
          <use value="work" />
          <type value="physical" />
          <line value="279 Yonge St" />
          <city value="Barrie" />
          <state value="ON" />
          <postalCode value="M5B 1N8" />
          <country value="CAN" />
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:25470f9e-0092-4997-af53-aa3ef0f50879" />
    <resource>
      <Location>
        <id value="25470f9e-0092-4997-af53-aa3ef0f50879" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Location|1.0.1" />
        </meta>
        <name value="Yonge Street Medical Office" />
        <address>
          <type value="physical" />
          <line value="279 Yonge St" />
          <city value="Barrie" />
          <state value="ON" />
          <postalCode value="M5B 1N8" />
          <country value="CAN" />
        </address>
        <position>
          <longitude value="-79.38248" />
          <latitude value="43.6556497" />
        </position>
      </Location>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:93584625-9dde-40b7-8313-9c00ac26cc93" />
    <resource>
      <DocumentReference>
        <id value="93584625-9dde-40b7-8313-9c00ac26cc93" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-DocumentReference|1.0.0" />
        </meta>
        <identifier>
          <system value="http://localhost:8080/svc/fhir/v1/NamingSystem/id-attachment-reference" />
          <value value="2440a55e-9c53-4925-8843-4ba670e1cb32" />
        </identifier>
        <status value="current" />
        <date value="2020-10-09T00:00:00+00:00" />
        <content>
          <attachment>
            <contentType value="application/pdf" />
            <url value="https://www.mcguffey.k12.pa.us/Downloads/Bingo%20Card.pdf" />
            <size value="11065" />
            <title value="Bingo%20Card.pdf" />
            <creation value="2020-09-09T00:00:00Z" />
          </attachment>
        </content>
        <context>
          <related>
            <reference value="ServiceRequest/x" />
          </related>
        </context>
      </DocumentReference>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:9cea3cb8-d24f-4be2-acbf-dbc6c3801493" />
    <resource>
      <QuestionnaireResponse>
        <id value="9cea3cb8-d24f-4be2-acbf-dbc6c3801493" />
        <meta>
          <profile value="http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-QuestionnaireResponse|1.0.0" />
        </meta>
        <identifier>
          <system value="http://www.rmssource.org/identifiers/questionnaire-ids" />
          <value value="9cea3cb8-d24f-4be2-acbf-dbc6c3801493" />
        </identifier>
        <status value="completed" />
        <subject>
          <reference value="urn:uuid:7f7ad826-f47b-4c18-9d4a-bd3d0988ad3b" />
        </subject>
        <authored value="2020-10-09" />
        <author>
          <reference value="urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8" />
        </author>
        <item>
          <linkId value="1" />
          <text value="Section 1 Header" />
          <item>
            <linkId value="1.1" />
            <text value="String Question in Section 1" />
            <answer>
              <valueString value="String Answer" />
            </answer>
          </item>
          <item>
            <linkId value="1.2" />
            <text value="Boolean Question in Section 1" />
            <answer>
              <valueBoolean value="true" />
            </answer>
          </item>
          <item>
            <linkId value="1.3" />
            <text value="Number Question in Section 1" />
            <answer>
              <valueInteger value="365" />
            </answer>
          </item>
          <item>
            <linkId value="1.4" />
            <text value="Decimal question in Section 1" />
            <answer>
              <valueDecimal value="364.9" />
            </answer>
          </item>
          <item>
            <linkId value="1.5" />
            <text value="DateTime Question in Section 2" />
            <answer>
              <valueDateTime value="2021-05-07T13:28:17Z" />
            </answer>
          </item>
        </item>
        <item>
          <linkId value="2" />
          <text value="Section 2 Header" />
          <item>
            <linkId value="2.1" />
            <text value="Integer Question in Section 2" />
            <answer>
              <valueInteger value="365" />
            </answer>
          </item>
          <item>
            <linkId value="2.2" />
            <text value="Multi-Select Question in Section 2" />
            <answer>
              <valueString value="tag1" />
            </answer>
            <answer>
              <valueString value="tag2" />
            </answer>
            <answer>
              <valueString value="tag3" />
            </answer>
          </item>
          <item>
            <linkId value="2.3" />
            <text value="Date Question in Section 2" />
            <answer>
              <valueDate value="2019-09-05" />
            </answer>
          </item>
          <item>
            <linkId value="2.4" />
            <text value="Time Question in Section 2" />
            <answer>
              <valueTime value="12:34:56" />
            </answer>
          </item>
        </item>
        <item>
          <linkId value="3" />
          <text value="CONDITIONAL Section 3 with Question" />
          <answer>
            <valueBoolean value="true" />
            <item>
              <linkId value="3.1" />
              <text value="Conditional Question 1:" />
              <answer>
                <valueString value="ConditionalAnswer1" />
              </answer>
            </item>
            <item>
              <linkId value="3.2" />
              <text value="Conditional Question 2:" />
              <answer>
                <valueString value="ConditionalAnswer2" />
              </answer>
            </item>
          </answer>
        </item>
      </QuestionnaireResponse>
    </resource>
  </entry>
</Bundle>