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Packagesmart.who.int.icvp
Resource TypeQuestionnaireResponse
IdQuestionnaireResponse-ICVPQRExample.json
FHIR VersionR4

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Narrative

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

Generated Narrative: QuestionnaireResponse ICVPQRExample

Profile: SDC Questionnaire Response

Tag: lformsVersion: 33.3.6 (Details: [not stated] code lformsVersion: 33.3.6)

LinkIDTextDefinitionAnswerdoco
.. ICVPQRExampleQuestionnaire:ICVP Model Questionnaire
... nameFull Name of the clientJohn Doe
... dobDate of Birth2017-05-17
... sexSexadministrativeSex M: Male
... nationalityNationalityISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code ATG: Antigua and Barbuda
... nidNational Identification DocumentASVPR24682C
... guardianParent or Guardian Details
.... guardianNameName of Parent or GuardianFather Doe
.... guardianRelationshipRelationship StatusDVCRelationshipStatus Parent: Parent
... vaccineDetailsVaccine Certificate Details
.... productIDVaccine or Prophylaxis IDICVPProductIds YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0: 01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé
.... dateDate of Vaccination2025-08-08
.... clinicianNameName of supervising clinicianMr. Supervisor
.... issuerRelevant authoring reponsible for issuing the certificate, or for overseeing the administration centerNational Health Institute
.... batchNoBatch Number23543657LOT
.... validityPeriodCertificate Validity Period
..... startDateFrom2025-08-15

doco Documentation for this format

Source1

{
  "resourceType": "QuestionnaireResponse",
  "id": "ICVPQRExample",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse"
    ],
    "tag": [
      {
        "code": "lformsVersion: 33.3.6"
      }
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "questionnaire": "http://smart.who.int/icvp/Questionnaire/ICVP",
  "status": "completed",
  "authored": "2025-08-08T08:16:27.352Z",
  "item": [
    {
      "linkId": "name",
      "text": "Full Name of the client",
      "answer": [
        {
          "valueString": "John Doe"
        }
      ]
    },
    {
      "linkId": "dob",
      "text": "Date of Birth",
      "answer": [
        {
          "valueDate": "2017-05-17"
        }
      ]
    },
    {
      "linkId": "sex",
      "text": "Sex",
      "answer": [
        {
          "valueCoding": {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0001",
            "code": "M",
            "display": "Male"
          }
        }
      ]
    },
    {
      "linkId": "nationality",
      "text": "Nationality",
      "answer": [
        {
          "valueCoding": {
            "system": "urn:iso:std:iso:3166",
            "code": "ATG"
          }
        }
      ]
    },
    {
      "linkId": "nid",
      "text": "National Identification Document",
      "answer": [
        {
          "valueString": "ASVPR24682C"
        }
      ]
    },
    {
      "linkId": "guardian",
      "text": "Parent or Guardian Details",
      "item": [
        {
          "linkId": "guardianName",
          "text": "Name of Parent or Guardian",
          "answer": [
            {
              "valueString": "Father Doe"
            }
          ]
        },
        {
          "linkId": "guardianRelationship",
          "text": "Relationship Status",
          "answer": [
            {
              "valueCoding": {
                "system": "http://smart.who.int/icvp/CodeSystem/DVCRelationshipStatus",
                "code": "Parent",
                "display": "Parent"
              }
            }
          ]
        }
      ]
    },
    {
      "linkId": "vaccineDetails",
      "text": "Vaccine Certificate Details",
      "item": [
        {
          "linkId": "productID",
          "text": "Vaccine or Prophylaxis ID",
          "answer": [
            {
              "valueCoding": {
                "system": "http://smart.who.int/icvp/CodeSystem/ICVPProductIds",
                "code": "YellowFeverProductd8a09f80301dc05e124f99ffe7711fc0",
                "display": "01/01/1987Yellow FeverSTAMARILVial + Ampoule10Sanofi PasteurAgence nationale de sécurité du médicament et des produits de santé"
              }
            }
          ]
        },
        {
          "linkId": "date",
          "text": "Date of Vaccination",
          "answer": [
            {
              "valueDate": "2025-08-08"
            }
          ]
        },
        {
          "linkId": "clinicianName",
          "text": "Name of supervising clinician",
          "answer": [
            {
              "valueString": "Mr. Supervisor"
            }
          ]
        },
        {
          "linkId": "issuer",
          "text": "Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center",
          "answer": [
            {
              "valueString": "National Health Institute"
            }
          ]
        },
        {
          "linkId": "batchNo",
          "text": "Batch Number",
          "answer": [
            {
              "valueString": "23543657LOT"
            }
          ]
        },
        {
          "linkId": "validityPeriod",
          "text": "Certificate Validity Period",
          "item": [
            {
              "linkId": "startDate",
              "text": "From",
              "answer": [
                {
                  "valueDate": "2025-08-15"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}