{

"resourceType": "QuestionnaireResponse",
"id": "3141",
"contained": [
  {
    "resourceType": "Patient",
    "id": "patsub",
    "identifier": [
      {
        "system": "http://cancer.questionnaire.org/systems/id/patientnr",
        "value": "A34442332"
      },
      {
        "type": {
          "text": "Dutch BSN"
        },
        "system": "urn:oid:2.16.840.1.113883.2.4.6.3",
        "value": "188912345"
      }
    ],
    "gender": "male",
    "birthDate": "1972-11-30"
  },
  {
    "resourceType": "ServiceRequest",
    "id": "order",
    "status": "unknown",
    "intent": "order",
    "subject": {
      "reference": "#patsub"
    },
    "requester": {
      "reference": "Practitioner/example"
    }
  },
  {
    "resourceType": "Practitioner",
    "id": "questauth",
    "identifier": [
      {
        "type": {
          "text": "AUMC, Den Helder"
        },
        "system": "http://cancer.questionnaire.org/systems/id/org",
        "value": "AUMC"
      }
    ]
  }
],
"identifier": {
  "system": "http://example.org/fhir/NamingSystem/questionnaire-ids",
  "value": "Q12349876"
},
"basedOn": [
  {
    "reference": "#order"
  }
],
"partOf": [
  {
    "reference": "Procedure/f201"
  }
],
"status": "completed",
"subject": {
  "reference": "#patsub"
},
"encounter": {
  "reference": "Encounter/example"
},
"authored": "2013-02-19T14:15:00-05:00",
"author": {
  "reference": "#questauth"
},
"item": [
  {
    "linkId": "1",
    "item": [
      {
        "linkId": "1.1",
        "answer": [
          {
            "valueCoding": {
              "system": "http://cancer.questionnaire.org/system/code/yesno",
              "code": "1",
              "display": "Yes"
            },
            "item": [
              {
                "linkId": "1.1.1",
                "item": [
                  {
                    "linkId": "1.1.1.1",
                    "answer": [
                      {
                        "valueCoding": {
                          "system": "http://cancer.questionnaire.org/system/code/yesno",
                          "code": "1"
                        }
                      }
                    ]
                  },
                  {
                    "linkId": "1.1.1.2",
                    "answer": [
                      {
                        "valueCoding": {
                          "system": "http://cancer.questionnaire.org/system/code/yesno",
                          "code": "1"
                        }
                      }
                    ]
                  },
                  {
                    "linkId": "1.1.1.3",
                    "answer": [
                      {
                        "valueCoding": {
                          "system": "http://cancer.questionnaire.org/system/code/yesno",
                          "code": "0"
                        }
                      }
                    ]
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  }
],
"meta": {
  "tag": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
      "code": "HTEST",
      "display": "test health data"
    }
  ]
}

}