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Source1

{
  "resourceType": "Patient",
  "id": "DecedentUT-Example1",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/NVSS-SexAtDeath",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/administrative-gender",
            "code": "male",
            "display": "Male"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
      "valueAddress": {
        "use": "old",
        "state": "CO",
        "country": "US"
      }
    }
  ],
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "SS"
          }
        ]
      },
      "system": "http://hl7.org/fhir/sid/us-ssn",
      "value": "429471420"
    }
  ],
  "name": [
    {
      "use": "official",
      "family": "Lineberry",
      "given": [
        "Davis"
      ],
      "suffix": [
        "Jr"
      ]
    }
  ],
  "gender": "male",
  "birthDate": "2021-03-04",
  "address": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetNumber",
          "valueString": "2722"
        },
        {
          "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/PreDirectional",
          "valueString": "N"
        },
        {
          "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetName",
          "valueString": "Pin Oak"
        },
        {
          "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/StreetDesignator",
          "valueString": "Dr"
        },
        {
          "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-within-city-limits-indicator-vr",
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
            "code": "Y",
            "display": "Yes"
          }
        }
      ],
      "line": [
        "2722 N Pin Oak Dr"
      ],
      "city": "Laramie",
      "_city": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CityCode",
            "valuePositiveInt": 45050
          }
        ]
      },
      "district": "Albany",
      "_district": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/DistrictCode",
            "valuePositiveInt": 1
          }
        ]
      },
      "state": "WY",
      "postalCode": "82070",
      "country": "US"
    }
  ],
  "maritalStatus": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag",
        "valueCodeableConcept": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/us/vr-common-library/CodeSystem/CodeSystem-vr-edit-flags",
              "code": "0",
              "display": "Edit Passed"
            }
          ]
        }
      }
    ],
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
        "code": "S",
        "display": "Never Married"
      }
    ]
  }
}