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Source1

{
  "resourceType": "Provenance",
  "id": "4ac851a6-e0dd-4f9b-a19f-45ac0ae0bea0",
  "meta": {
    "lastUpdated": "2021-02-08T14:21:07.5320994+00:00",
    "profile": [
      "http://fhir.de/ConsentManagement/StructureDefinition/Provenance"
    ]
  },
  "target": [
    {
      "reference": "QuestionnaireResponse/02eac854-6a2e-48f9-88d7-edd04faff81c"
    }
  ],
  "recorded": "2020-12-11T09:39:07+00:00",
  "agent": [
    {
      "who": {
        "display": "Snakeoil Soft Consent Manager 2021"
      }
    }
  ],
  "entity": [
    {
      "role": "source",
      "what": {
        "reference": "DocumentReference/237c359c-cb58-432c-a4a3-807bb28edfdb"
      }
    }
  ],
  "signature": [
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      "extension": [
        {
          "url": "http://fhir.de/ConsentManagement/StructureDefinition/SignatureLocation",
          "valueString": "Untertal"
        }
      ],
      "type": [
        {
          "system": "urn:iso-astm:E1762-95:2013",
          "code": "1.2.840.10065.1.12.1.7",
          "display": "Consent Signature"
        }
      ],
      "when": "2020-12-11T09:39:07+00:00",
      "who": {
        "reference": "Patient/9b4a702d-162c-428a-8c5d-8b98af21b693"
      },
      "data": "RGllcyBpc3QgZWluIEJhc2U2NC1jb2RpZXJ0ZXIgU3RyaW5n"
    },
    {
      "extension": [
        {
          "url": "http://fhir.de/ConsentManagement/StructureDefinition/SignatureLocation",
          "valueString": "Musterstadt"
        }
      ],
      "type": [
        {
          "system": "urn:iso-astm:E1762-95:2013",
          "code": "1.2.840.10065.1.12.1.5",
          "display": "Verification Signature"
        }
      ],
      "when": "2020-12-11T09:39:07+00:00",
      "who": {
        "display": "Dr. F. Müller"
      },
      "onBehalfOf": {
        "display": "Krankenhaus Musterstadt"
      },
      "data": "QUcgRVdFIEZISVIgcm9ja3M="
    }
  ]
}