SMART ICVP
0.2.0 - release

This page is part of the ICVP (v0.2.0: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 0.3.0. For a full list of available versions, see the Directory of published versions

Example 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