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Source1

{
  "resourceType": "Patient",
  "id": "PDS-Patient-MultipleLanguagesComplex-Example",
  "meta": {
    "profile": [
      "https://fhir.nhs.uk/England/StructureDefinition/England-Patient-PDS"
    ]
  },
  "name": [
    {
      "use": "official",
      "family": "Einstein",
      "given": [
        "Albert"
      ]
    }
  ],
  "gender": "male",
  "birthDate": "1879-03-14",
  "address": [
    {
      "use": "home",
      "line": [
        "35 Market St",
        "Kirkby Stephen",
        "Cumbria"
      ],
      "postalCode": "CA17 4QN"
    }
  ],
  "communication": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency",
          "extension": [
            {
              "url": "level",
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
                "code": "E",
                "display": "Excellent"
              }
            }
          ]
        }
      ],
      "language": {
        "coding": [
          {
            "system": "urn:ietf:bcp:47",
            "code": "en",
            "display": "English"
          }
        ]
      }
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency",
          "extension": [
            {
              "url": "level",
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
                "code": "P",
                "display": "Poor"
              }
            },
            {
              "url": "type",
              "valueCoding": {
                "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode",
                "code": "ESP",
                "display": "Expressed spoken"
              }
            }
          ]
        }
      ],
      "language": {
        "coding": [
          {
            "system": "urn:ietf:bcp:47",
            "code": "de",
            "display": "German"
          }
        ]
      },
      "preferred": true
    }
  ]
}