<?xml version=“1.0” encoding=“UTF-8”?> <QuestionnaireResponse xmlns=“hl7.org/fhir”>

<id value="3141"/>
<meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>

<contained>
  <Patient>
    <id value="patsub"/>
    <identifier>
      <system value="http://cancer.questionnaire.org/systems/id/patientnr"/>
      <value value="A34442332"/>
    </identifier>
    <identifier>
      <type>
        <text value="Dutch BSN"/>
      </type>
      <system value="urn:oid:2.16.840.1.113883.2.4.6.3"/>
      <value value="188912345"/>
    </identifier>
    <gender value="male"/>
    <birthDate value="1972-11-30"/>
  </Patient>
</contained>
<contained>
  <ServiceRequest>
    <id value="order"/>
    <status value="unknown"/>
    <intent value="order"/>
    <subject>
      <reference value="#patsub"/>
    </subject>
    <requester>
        <reference value="Practitioner/example"/>
    </requester>
  </ServiceRequest>
</contained>
<contained>
  <Practitioner>
    <id value="questauth"/>
    <identifier>
      <type>
        <text value="AUMC, Den Helder"/>
      </type>
      <system value="http://cancer.questionnaire.org/systems/id/org"/>
      <value value="AUMC"/>
    </identifier>
  </Practitioner>
</contained>
<!--    TODO: decide how to do this
<contained>

  <Observation>
    <id value="obs.pt-category"/>
    <status value="final"/>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="53786006"/>
        <display value="pT1 category"/>
      </coding>
    </code>
    <subject>
      <reference value="#patsub"/>
    </subject>
    <performer>
      <reference value="#questauth"/>
    </performer>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="443357004"/>
        <display value="pT1a category"/>
      </coding>
    </valueCodeableConcept>
  </Observation>
</contained>  -->
<identifier>
  <system value="http://example.org/fhir/NamingSystem/questionnaire-ids"/>
  <value value="Q12349876"/>
</identifier>
<basedOn>
  <reference value="#order"/>
</basedOn>
<partOf>
  <reference value="Procedure/f201"/>
</partOf>
<status value="completed"/>
<subject>
  <reference value="#patsub"/>
</subject>
<encounter>
  <reference value="Encounter/example"/>
</encounter>
<authored value="2013-02-19T14:15:00-05:00"/>
<author>
  <reference value="#questauth"/>
</author>
<item>
  <!--    COMORBIDITY    -->
  <!--    First main section of the form, questions about comorbidity    -->
  <!--    section contains one question: whether there is comorbidity    -->
  <linkId value="1"/>
  <item>
    <linkId value="1.1"/>
    <answer>
      <valueCoding>
        <system value="http://cancer.questionnaire.org/system/code/yesno"/>
        <code value="1"/>
        <display value="Yes"/>
      </valueCoding>
      <item>
        <!--    COMORBIDITY/CARDIAL    -->
        <!--    Subsection about specific comorbidity: cardial    -->
        <linkId value="1.1.1"/>
        <item>
          <linkId value="1.1.1.1"/>
          <answer>
            <valueCoding>
              <system value="http://cancer.questionnaire.org/system/code/yesno"/>
              <code value="1"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <!--    This answer carries both the questionnaire-specific name and an equivalent SNOMED CT code    -->
          <linkId value="1.1.1.2"/>
          <answer>
            <valueCoding>
              <system value="http://cancer.questionnaire.org/system/code/yesno"/>
              <code value="1"/>
            </valueCoding>
          </answer>
        </item>
        <item>
          <linkId value="1.1.1.3"/>
          <answer>
            <valueCoding>
              <system value="http://cancer.questionnaire.org/system/code/yesno"/>
              <code value="0"/>
            </valueCoding>
          </answer>
        </item>
      </item>
    </answer>
  </item>
</item>
<!--    HISTOPATHOLOGY    -->
<!--    TODO: decide how to do this
<item>

  <item>
    <item>
     <dataResource>
        <reference value="#obs.pt-category"/>
      </dataResource>
    </item>
  </item>
</item>    -->

</QuestionnaireResponse>