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<?xml version="1.0" encoding="UTF-8"?>
<?xml-stylesheet type="text/xsl" href="CDA.xsl"?>
<ClinicalDocument
xmlns = "urn:hl7-org:v3"
xmlns:xsi = "http://www.w3.org/2001/XMLSchema-instance"
xmlns:voc = "urn:hl7-org:v3/voc"
xmlns:sdtc = "urn:hl7-org:sdtc">
<realmCode code = "US"/>
<typeId extension = "POCD_HD000040" root = "2.16.840.1.113883.1.3"/>
<templateId root = "2.16.840.1.113883.10.20.22.1.1" extension = "2015-08-01"/>
<templateId root = "2.16.840.1.113883.10.20.22.1.1"/>
<templateId root = "2.16.840.1.113883.10.20.22.1.2" extension = "2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.1.2" />
<id root="3db70aff-83f5-4caf-91dc-d23fcc5e03bb" />
<code code="34133-9" displayName="Summarization of Episode Note"
codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
<title>Medical Summary</title>
<effectiveTime value="20250101000000-0500" />
<languageCode code="en-US" />
<recordTarget>
<patientRole>
<id root="ce862cfe-6559-411e-92e9-e8d005b1c226" />
<id extension="111223333" root="2.16.840.1.113883.4.1" />
<telecom nullFlavor="UNK" />
<addr nullFlavor="UNK" />
<patient>
<name use="L">
<given>Katherine</given>
<family>Madison</family>
</name>
<raceCode nullFlavor="UNK"/>
<ethnicGroupCode nullFlavor="UNK"/>
</patient>
</patientRole>
</recordTarget>
<component>
<structuredBody>
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.10" />
<templateId root="2.16.840.1.113883.10.20.22.2.10" extension="2014-06-09" />
<!-- **** Plan of Care section template **** -->
<code
code="18776-5"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Treatment plan" />
<title>CARE PLAN</title>
<text>
<table
border="1"
width="100%">
<thead>
<tr>
<th>Planned Activity</th>
<th>Planned Date</th>
</tr>
</thead>
<tbody>
<tr>
<td>Admit Yourself to Community Health and Hospitals for Pnuemonia</td>
<td>20120806</td>
</tr>
</tbody>
</table>
</text>
<entry>
<act
classCode="ACT"
moodCode="INT">
<templateId
root="2.16.840.1.113883.10.20.22.4.20" />
<id root="3f8b4e4c-7abc-40eb-b8d0-df32e46c086a" />
<!-- ** Instructions Template ** -->
<code xsi:type="CD"
code="409073007"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"
displayName="instruction" />
<text>Admit Yourself to Community Health and Hospitals for Pnuemonia</text>
<statusCode
code="completed" />
</act>
</entry>
</section>
</component>
</structuredBody>
</component>
</ClinicalDocument>