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Narrative

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

Generated Narrative: Questionnaire PreQual

Profile: Extractable Questionnaire - StructureMap

LinkID	Text	Cardinality	Type	Description & Constraints
	Questionnaire for DVC Logical Model with the WHO PreQual DB		Questionnaire	http://smart.who.int/trust-phw/Questionnaire/PreQual#0.1.0
name	Full Name of the client	0..*	string
dob	Date of Birth	0..*	date
sex	Sex	0..1	choice	Value Set: hl7VS-administrativeSex
nationality	Nationality	0..1	choice	Value Set: Country
nid	National Identification Document	0..1	string
ndt	National ID Document Type	0..1	choice	Value Set: hl7VS-identifierType
guardian	Parent or Guardian Details	0..1	group
guardianName	Name of Parent or Guardian	0..1	string
vaccineDetails	Vaccine Certificate Details	1..*	group
productID	Vaccine or Prophylaxis ID	0..*	choice	Value Set: WHO PreQualificaiton Vaccine Product Ids
date	Date of Vaccination	0..*	date
clinicianName	Name of supervising clinician	0..1	string
issuer	Relevant authoring responsible for issuing the certificate, or for overseeing the administration center	0..1	string
batchNo.text	Batch Number	0..*	string
validityPeriod	Certificate Validity Period	0..1	group
startDate	From	0..1	date
endDate	To	0..1	date
attachment	Upload Paper Form image or PDF	0..1	attachment
Documentation for this format

Source1

{
  "resourceType": "Questionnaire",
  "id": "PreQual",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "url": "http://smart.who.int/trust-phw/Questionnaire/PreQual",
  "version": "0.1.0",
  "title": "DVC Model Questionnaire",
  "status": "active",
  "date": "2026-01-19T12:42:09+00:00",
  "publisher": "WHO",
  "contact": [
    {
      "name": "WHO",
      "telecom": [
        {
          "system": "url",
          "value": "http://who.int"
        }
      ]
    }
  ],
  "description": "Questionnaire for DVC Logical Model with the WHO PreQual DB",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "item": [
    {
      "linkId": "name",
      "text": "Full Name of the client",
      "type": "string",
      "required": false,
      "repeats": true
    },
    {
      "linkId": "dob",
      "text": "Date of Birth",
      "type": "date",
      "required": false,
      "repeats": true
    },
    {
      "linkId": "sex",
      "text": "Sex",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0001"
    },
    {
      "linkId": "nationality",
      "text": "Nationality",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "http://terminology.hl7.org/ValueSet/v3-Country"
    },
    {
      "linkId": "nid",
      "text": "National Identification Document",
      "type": "string",
      "required": false,
      "repeats": false
    },
    {
      "linkId": "ndt",
      "text": "National ID Document Type",
      "type": "choice",
      "required": false,
      "repeats": false,
      "answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0203"
    },
    {
      "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": "vaccineDetails",
      "text": "Vaccine Certificate Details",
      "type": "group",
      "required": true,
      "repeats": true,
      "item": [
        {
          "linkId": "productID",
          "text": "Vaccine or Prophylaxis ID",
          "type": "choice",
          "required": false,
          "repeats": true,
          "answerValueSet": "http://smart.who.int/pcmt-vaxprequal/ValueSet/PreQualProductIds"
        },
        {
          "linkId": "date",
          "text": "Date of Vaccination",
          "type": "date",
          "required": false,
          "repeats": true
        },
        {
          "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": false,
          "repeats": true
        },
        {
          "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
            }
          ]
        }
      ]
    },
    {
      "linkId": "attachment",
      "text": "Upload Paper Form image or PDF",
      "type": "attachment",
      "required": false,
      "repeats": false
    }
  ]
}