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Packagesmart.who.int.icvp
Resource TypeQuestionnaire
IdQuestionnaire-ICVP.json
FHIR VersionR4
Sourcehttp://smart.who.int/icvp/0.2.0/Questionnaire-ICVP.html
URLhttp://smart.who.int/icvp/Questionnaire/ICVP
Version0.2.0
Statusactive
Date2025-10-08T14:32:12+00:00
TitleICVP Model Questionnaire
Authoritywho
DescriptionQuestionnaire for DVC Logical Model with the WHO ICVP

Resources that use this resource

No resources found


Resources that this resource uses

No resources found


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Questionnaire ICVP

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. Questionnaire for DVC Logical Model with the WHO ICVPQuestionnairehttp://smart.who.int/icvp/Questionnaire/ICVP#0.2.0
... nameFull Name of the client1..1string
... dobDate of Birth1..1date
... sexSex0..1choiceValue Set: v2 SEX
... nationalityNationality0..1choiceValue Set: Country
... ndtNational ID Document Type0..1choiceValue Set: hl7VS-identifierType
... nidNational Identification Document0..1string
... guardianParent or Guardian Details0..1group
.... guardianNameName of Parent or Guardian0..1string
.... guardianRelationshipRelationship Status0..1choiceValue Set: Relationship Status for Contact in Patient
... vaccineDetailsVaccine Certificate Details1..*group
.... productIDVaccine or Prophylaxis ID1..1choiceValue Set: WHO ICVP Vaccine Product Ids
.... dateDate of Vaccination1..1date
.... clinicianNameName of supervising clinician0..1string
.... issuerRelevant authoring responsible for issuing the certificate, or for overseeing the administration center0..1string
.... batchNo.textBatch Number1..1string
.... validityPeriodCertificate Validity Period0..1group
..... startDateFrom0..1date
..... endDateTo0..1date

doco Documentation for this format

Contained Resources


ValueSet #v3-Country

Language: en

  • Include codes fromurn:iso:std:iso:3166 version Not Stated (use latest from terminology server) where code matches (by regex) [A-Z]{3}

ValueSet #v2-0001

Language: en

Profile: Shareable ValueSet


ValueSet #ICVPProductIds


ValueSet #DVCRelationshipStatus


Source1

{
  "resourceType": "Questionnaire",
  "id": "ICVP",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "ValueSet",
      "id": "v3-Country",
      "language": "en",
      "text": {
        "status": "generated",
        "div": "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet v3-Country</b></p><a name=\"v3-Country\"> </a><a name=\"hcv3-Country\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><ul><li>Include codes from<a href=\"CodeSystem-ISO3166Part1.html\"><code>urn:iso:std:iso:3166</code></a> where code  matches (by regex) [A-Z]{3}</li></ul></div>"
      },
      "url": "http://terminology.hl7.org/ValueSet/v3-Country",
      "identifier": [
        {
          "system": "urn:ietf:rfc:3986",
          "value": "urn:oid:2.16.840.1.113883.1.11.171"
        }
      ],
      "version": "3.0.0",
      "name": "Country",
      "title": "Country",
      "status": "active",
      "experimental": false,
      "date": "2014-03-26",
      "publisher": "Health Level Seven International",
      "contact": [
        {
          "telecom": [
            {
              "system": "url",
              "value": "http://hl7.org"
            },
            {
              "system": "email",
              "value": "hq@HL7.org"
            }
          ]
        }
      ],
      "description": "Countries of the world. ISO 3166, part 1, alpha-3 set.",
      "copyright": "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
      "compose": {
        "include": [
          {
            "system": "urn:iso:std:iso:3166",
            "filter": [
              {
                "property": "code",
                "op": "regex",
                "value": "[A-Z]{3}"
              }
            ]
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "v2-0001",
      "meta": {
        "profile": [
          "http://hl7.org/fhir/StructureDefinition/shareablevalueset"
        ]
      },
      "language": "en",
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
          "valueCode": "external"
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
          "valueInteger": 0
        }
      ],
      "url": "http://terminology.hl7.org/ValueSet/v2-0001",
      "version": "2.9",
      "name": "v2.0001",
      "title": "v2 SEX",
      "status": "active",
      "experimental": false,
      "publisher": "HL7, Inc",
      "contact": [
        {
          "telecom": [
            {
              "system": "url",
              "value": "http://hl7.org"
            }
          ]
        }
      ],
      "description": "FHIR Value set/code system definition for HL7 v2 table 0001 ( SEX)",
      "immutable": true,
      "compose": {
        "include": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0001"
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "ICVPProductIds",
      "url": "http://smart.who.int/icvp/ValueSet/ICVPProductIds",
      "name": "ICVPProductIds",
      "title": "WHO ICVP Vaccine Product Ids",
      "status": "active",
      "experimental": true,
      "description": "WHO ICVP Vaccine Product Ids",
      "compose": {
        "include": [
          {
            "system": "http://smart.who.int/pcmt-vaxprequal/CodeSystem/PreQualProductIds",
            "concept": [
              {
                "code": "YellowFeverProductd2c75a15ed309658b3968519ddb31690",
                "display": "26/03/2009Yellow Fevern/aAmpoule2Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
              },
              {
                "code": "YellowFeverProduct771d1a5c0acaee3e2dc9d56af1aba49d",
                "display": "26/03/2009Yellow Fevern/aAmpoule5Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
              },
              {
                "code": "YellowFeverProducte929626497bdbb71adbe925f0c09c79f",
                "display": "26/03/2009Yellow Fevern/aAmpoule10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
              },
              {
                "code": "YellowFeverProduct01a3b83cf13e87948437db11cf5c34eb",
                "display": "14/10/2022Yellow FeverSinSaVac™Vial10Federal State Autonomous Scientific Institution «Chumakov Federal Scientific Center for Research & Development of Immune-And Biological Products», Russian Academy of SciencesFederal Service on Surveillance in Healthcare (ROSZDRAVNADZOR) of the Russian Federation"
              },
              {
                "code": "YellowFeverProductf82b015dfb3b1feeacd4c44d95b3b3ec",
                "display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule5Institut Pasteur de DakarMinistère de la Santé publique"
              },
              {
                "code": "YellowFeverProduct223330a7c15da86b21cc363f591de002",
                "display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule10Institut Pasteur de DakarMinistère de la Santé publique"
              },
              {
                "code": "YellowFeverProductffea8448252ee58b7a92add05f0c3431",
                "display": "20/03/2001Yellow FeverStabilized Yellow Fever VaccineAmpoule20Institut Pasteur de DakarMinistère de la Santé publique"
              },
              {
                "code": "YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0",
                "display": "01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé"
              },
              {
                "code": "YellowFeverProductab01f006f8b24113f4a28cb50bfe6d9d",
                "display": "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)5Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
              },
              {
                "code": "YellowFeverProduct5f0639d8e4d52afef089aa7148c5060c",
                "display": "10/12/2007Yellow FeverYellow FeverTwo vial set (active + excipient)10Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
              },
              {
                "code": "YellowFeverProducte0534dbc71a6cc09f56dce25216c538c",
                "display": "17/10/2001Yellow FeverYellow FeverTwo vial set (active + excipient)50Bio-Manguinhos/FiocruzAgencia Nacional da Vigilancia Sanitaria"
              },
              {
                "code": "PolioVaccineOralOPVTrivaProductfa4849f7532d522134f4102063af1617",
                "display": "20/03/2015Polio Vaccine - Oral (OPV) TrivalentBIOPOLIOVial10Bharat Biotech International LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVTrivaProduct4df3a93ab495d85b3583d0cd1ae3d83e",
                "display": "20/03/2015Polio Vaccine - Oral (OPV) TrivalentBIOPOLIOVial20Bharat Biotech International LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct16e883911ea0108b8213bc213c9972fe",
                "display": "25/08/2017Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3BIOPOLIO B1/3Vial10Bharat Biotech International LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct0e59118bc5938520115bac65a45be04d",
                "display": "20/03/2015Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3BIOPOLIO B1/3Vial20Bharat Biotech International LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProductb62fbc87532804be42afa8d9050ef452",
                "display": "16/11/2021Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent OPV Type 1 and 3 Poliomyelitis Vaccine, Live (Oral)Vial10Panacea Biotec Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct02c099d69cd245e7fcd3280a96f1dccb",
                "display": "07/12/2018Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent OPV Type 1 and 3 Poliomyelitis Vaccine, Live (Oral)Vial20Panacea Biotec Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProductdecf3a77facc0b8f1443db5f7a806857",
                "display": "05/11/2015Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent Oral Poliomyelitis Vaccine Type 1&3 (bOPV 1&3)Vial10PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct10aa94cef126e62542c2c45dc3604c0b",
                "display": "26/05/2010Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent Oral Poliomyelitis Vaccine Type 1&3 (bOPV 1&3)Vial20PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct26e6c50dfb385f223a12238dc6e202dd",
                "display": "19/03/2010Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Bivalent type 1&3 Oral Poliomyelitis vaccine, IP (bOPV1&3)Vial20Haffkine Bio Pharmaceutical Corporation LtdCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedSProduct0854d534a200bbeffa8be0f57dad584a",
                "display": "01/06/2021Polio Vaccine - Inactivated Sabin (sIPV)Eupolio Inj.Vial1LG Chem LtdMinistry of Food and Drug Safety"
              },
              {
                "code": "PolioVaccineInactivatedSProduct031f63df3184acdf0cb82f90f316b6c3",
                "display": "21/12/2020Polio Vaccine - Inactivated Sabin (sIPV)Eupolio Inj.Vial5LG Chem LtdMinistry of Food and Drug Safety"
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              {
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              {
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              },
              {
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              },
              {
                "code": "PolioVaccineInactivatedIProduct532ef986c8042bbb15fee24056fdc4ed",
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              },
              {
                "code": "PolioVaccineInactivatedIProduct087ff26057e89c006517428347dfbc3c",
                "display": "23/12/2010Polio Vaccine - Inactivated (IPV)IPV Vaccine AJVVial1AJ Vaccines A/SDanish Medicines Agency"
              },
              {
                "code": "PolioVaccineOralOPVMonovProductcea74be2c728329aad7b9b33ae16a0b1",
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              },
              {
                "code": "PolioVaccineOralOPVMonovProductef716e2b9567223ce6c95b090480ecfe",
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              },
              {
                "code": "PolioVaccineOralOPVMonovProductae7e506ca48a3aa605b188cd11eaceab",
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              },
              {
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              {
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              },
              {
                "code": "PolioVaccineInactivatedIProduct096d9e8c31e30cc1148311ee66359a50",
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              },
              {
                "code": "PolioVaccineOralOPVMonovProduct7d442364610244382098e1c4a3ba54c3",
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              {
                "code": "PolioVaccineOralOPVMonovProduct4580ab03228ed6c70bb6c117b408f7e5",
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              },
              {
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              },
              {
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              },
              {
                "code": "PolioVaccineOralOPVMonovProduct1b2bdb769d38e0b45eb60707ff9a36cb",
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              },
              {
                "code": "PolioVaccineOralOPVMonovProductb4755cab194f57a5fecc8d890856bbdf",
                "display": "11/05/2011Polio Vaccine - Oral (OPV) Monovalent Type 2Polio Sabin Mono Two (oral)Vial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct14c88c2e9b35698b4726903940c58037",
                "display": "29/10/2009Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Polio Sabin One and ThreeVial10GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct2d10261076734e48cd7b289de6ea802e",
                "display": "29/10/2009Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Polio Sabin One and ThreeVial20GlaxoSmithKline Biologicals SAFederal Agency for Medicines and Health Products"
              },
              {
                "code": "PolioVaccineInactivatedIProductc726fd7210023aa5738617a79cae2b40",
                "display": "06/12/2010Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccineVial1Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)"
              },
              {
                "code": "PolioVaccineNovelOralnOPProduct65b137f0201901bc43fc8759e4f35f35",
                "display": "29/07/2024Polio Vaccine - Novel Oral (nOPV) Type 2Poliomyelitis Vaccine - Novel Oral (nOPV) Type 2Vial20Biological E. LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineNovelOralnOPProduct278e9af5dc50904dd144a7ceb4d42dd7",
                "display": "27/12/2023Polio Vaccine - Novel Oral (nOPV) Type 2Polio Vaccine - Novel Oral (nOPV) Type 2Vial50PT Bio Farma (Persero)National Agency of Drug and Food Control Indonesia"
              },
              {
                "code": "PolioVaccineNovelOralnOPProductab7589153ddbc7968e1749119c5b1678",
                "display": "29/07/2024Polio Vaccine - Novel Oral (nOPV) Type 2Poliomyelitis Vaccine - Novel Oral (nOPV) Type 2Vial50Biological E. LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProduct1d63ab46cee67d02439c47ed91439667",
                "display": "28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial1Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProduct13e82343f8e192fe6e3fbfbf2a47ffd7",
                "display": "28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial2Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProductf8085a2bd9a1c84fba1adee2ec6f6fb1",
                "display": "28/10/2016Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial5Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProductfea93261bf2f096ea48aed825522dc2d",
                "display": "11/07/2019Polio Vaccine - Inactivated (IPV)Poliomyelitis Vaccine (Inactivated)Vial10Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProductdcbfa0a541c65032a917c39fa762c2f9",
                "display": "21/12/2017Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (live, oral attenuated, human Diploid Cell), type 1 and 3Vial20Beijing Institute of Biological Products Co., Ltd.National Medical Products Administration"
              },
              {
                "code": "PolioVaccineOralOPVBivalProduct06bf2d06adcc6d9e2bea8ac21846bb09",
                "display": "22/10/2014Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (Oral), Bivalent types 1 and 3Vial10Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineOralOPVBivalProducta5416e91021f0c00915e4688ff508717",
                "display": "04/02/2013Polio Vaccine - Oral (OPV) Bivalent Types 1 and 3Poliomyelitis Vaccine (Oral), Bivalent types 1 and 3Vial20Serum Institute of India Pvt. Ltd.Central Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedSProduct2050ea67709cfcde28a01f0546276e96",
                "display": "06/06/2022Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial1Sinovac Biotech Co. LtdNational Medical Products Administration"
              },
              {
                "code": "PolioVaccineInactivatedSProduct25383b1f589d42af3719c7074f982c9b",
                "display": "15/02/2022Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial1Beijing Institute of Biological Products Co., Ltd.National Medical Products Administration"
              },
              {
                "code": "PolioVaccineInactivatedSProductd554f4c3848920ca8bcd00d44afd18a4",
                "display": "29/08/2024Polio Vaccine - Inactivated Sabin (sIPV)Poliomyelitis Vaccine (Vero Cell), Inactivated, Sabin StrainsVial5Sinovac Biotech Co. LtdNational Medical Products Administration"
              },
              {
                "code": "PolioVaccineInactivatedIProduct3cde3a30cacdc23b9ec3bdf4ba9d23ff",
                "display": "28/11/2014Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccine multidoseVial5Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)"
              },
              {
                "code": "PolioVaccineInactivatedIProduct4562bbd80c6e57dbe29b122817623854",
                "display": "29/02/2024Polio Vaccine - Inactivated (IPV)Poliomyelitis vaccine multidoseVial10Bilthoven Biologicals B.V.Medicines Evaluation Board (MEB)"
              },
              {
                "code": "PolioVaccineOralOPVTrivaProductbd7faeaf3f0e633420fba396895d6cc9",
                "display": "02/02/2006Polio Vaccine - Oral (OPV) TrivalentPolioviral vaccineVial20Haffkine Bio Pharmaceutical Corporation LtdCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProduct81ee9ba77c4419bbfe44a27cfd10027e",
                "display": "01/10/2018Polio Vaccine - Inactivated (IPV)ShanIPV™Vial5Sanofi Healthcare India Private LimitedCentral Drugs Standard Control Organization"
              },
              {
                "code": "PolioVaccineInactivatedIProduct8b13b5fcf5e9268b345775be7c3f077c",
                "display": "22/04/2022Polio Vaccine - Inactivated (IPV)ShanIPV™Vial10Sanofi Healthcare India Private LimitedCentral Drugs Standard Control Organization"
              }
            ]
          }
        ]
      }
    },
    {
      "resourceType": "ValueSet",
      "id": "DVCRelationshipStatus",
      "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet DVCRelationshipStatus</b></p><a name=\"DVCRelationshipStatus\"> </a><a name=\"hcDVCRelationshipStatus\"> </a><ul><li>Include all codes defined in <a href=\"CodeSystem-DVCRelationshipStatus.html\"><code>http://smart.who.int/trust-phw/CodeSystem/DVCRelationshipStatus</code></a> version <span title=\"Version is not explicitly stated, which means it is fixed to the version provided in this specification\">&#x1F4E6;0.1.0</span></li></ul></div>"
      },
      "url": "http://smart.who.int/trust-phw/ValueSet/DVCRelationshipStatus",
      "version": "0.1.0",
      "name": "DVCRelationshipStatus",
      "title": "Relationship Status for Contact in Patient",
      "status": "draft",
      "date": "2025-10-07T06:40:24+00:00",
      "publisher": "WHO",
      "contact": [
        {
          "name": "WHO",
          "telecom": [
            {
              "system": "url",
              "value": "http://who.int"
            }
          ]
        }
      ],
      "description": "Relationship Status for Contact in Patient",
      "jurisdiction": [
        {
          "coding": [
            {
              "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code": "001",
              "display": "World"
            }
          ]
        }
      ],
      "compose": {
        "include": [
          {
            "system": "http://smart.who.int/trust-phw/CodeSystem/DVCRelationshipStatus"
          }
        ]
      }
    }
  ],
  "url": "http://smart.who.int/icvp/Questionnaire/ICVP",
  "version": "0.2.0",
  "title": "ICVP Model Questionnaire",
  "status": "active",
  "date": "2025-10-08T14:32:12+00:00",
  "publisher": "WHO",
  "contact": [
    {
      "name": "WHO",
      "telecom": [
        {
          "system": "url",
          "value": "http://who.int"
        }
      ]
    }
  ],
  "description": "Questionnaire for DVC Logical Model with the WHO ICVP",
  "item": [
    {
      "linkId": "name",
      "text": "Full Name of the client",
      "type": "string",
      "required": true,
      "repeats": false
    },
    {
      "linkId": "dob",
      "text": "Date of Birth",
      "type": "date",
      "required": true,
      "repeats": false
    },
    {
      "linkId": "sex",
      "text": "Sex",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "#v2-0001"
    },
    {
      "linkId": "nationality",
      "text": "Nationality",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "#v3-Country"
    },
    {
      "linkId": "ndt",
      "text": "National ID Document Type",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0203"
    },
    {
      "linkId": "nid",
      "text": "National Identification Document",
      "type": "string",
      "required": false,
      "repeats": false
    },
    {
      "linkId": "guardian",
      "text": "Parent or Guardian Details",
      "type": "group",
      "required": false,
      "repeats": false,
      "item": [
        {
          "linkId": "guardianName",
          "text": "Name of Parent or Guardian",
          "type": "string",
          "required": false,
          "repeats": false
        },
        {
          "linkId": "guardianRelationship",
          "text": "Relationship Status",
          "type": "choice",
          "required": false,
          "repeats": false,
          "answerValueSet": "#DVCRelationshipStatus"
        }
      ]
    },
    {
      "linkId": "vaccineDetails",
      "text": "Vaccine Certificate Details",
      "type": "group",
      "required": true,
      "repeats": true,
      "item": [
        {
          "linkId": "productID",
          "text": "Vaccine or Prophylaxis ID",
          "type": "choice",
          "required": true,
          "repeats": false,
          "answerValueSet": "#ICVPProductIds"
        },
        {
          "linkId": "date",
          "text": "Date of Vaccination",
          "type": "date",
          "required": true,
          "repeats": false
        },
        {
          "linkId": "clinicianName",
          "text": "Name of supervising clinician",
          "type": "string",
          "required": false,
          "repeats": false
        },
        {
          "linkId": "issuer",
          "text": "Relevant authoring responsible for issuing the certificate, or for overseeing the administration center",
          "type": "string",
          "required": false,
          "repeats": false
        },
        {
          "linkId": "batchNo.text",
          "text": "Batch Number",
          "type": "string",
          "required": true,
          "repeats": false
        },
        {
          "linkId": "validityPeriod",
          "text": "Certificate Validity Period",
          "type": "group",
          "required": false,
          "repeats": false,
          "item": [
            {
              "linkId": "startDate",
              "text": "From",
              "type": "date",
              "required": false,
              "repeats": false
            },
            {
              "linkId": "endDate",
              "text": "To",
              "type": "date",
              "required": false,
              "repeats": false
            }
          ]
        }
      ]
    }
  ]
}