Polska Implementacja Krajowa HL7 CDA (plcda-)

eZdrowie - Projekt P1

Przykłady - [1] Dokument skierowania

Skierowanie na kardiologię [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie na kardiologię -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="2345678" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57832-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescription for diagnostic or specialist care Document">
    <translation code="02.10" displayName="Skierowanie na badanie lub leczenie" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1"/>
  </code>
  <title>Skierowanie do szpitala</title>
  <effectiveTime value="20141020"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="432231" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="12345" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="62091599999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>01-134</postalCode>
        <streetName>Odkryta</streetName>
        <houseNumber>41</houseNumber>
        <unitID>12</unitID>
      </addr>
      <patient>
        <name>
          <given>Jan</given>
          <given>Franciszek</given>
          <family>Kowalski</family>
        </name>
        <birthTime value="19620915"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20141020"/>
    <assignedAuthor>
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
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  </custodian>
  <legalAuthenticator>
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    <templateId root="2.16.840.1.113883.3.4424.13.10.2.27"/>
    <time value="20141020"/>
    <signatureCode code="S"/>
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        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>lek.</prefix>
          <given>Piotr</given>
          <family>Nowak</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0718" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="neurologia"/>
        </extPL:qualifiedEntity>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0726" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="radiologia i diagnostyka obrazowa"/>
        </extPL:qualifiedEntity>
      </assignedPerson>
      <representedOrganization>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.17"/>
        <id extension="1007-01" root="2.16.840.1.113883.3.4424.2.3.2" displayable="true"/>
        <name>Poradnia POZ</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <telecom use="PUB" value="fax:22-1111100"/>
        <addr>
          <postalCode>00-950</postalCode>
          <city>Warszawa</city>
          <streetName>Marszałkowska</streetName>
          <houseNumber>320</houseNumber>
        </addr>
        <asOrganizationPartOf>
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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            <id extension="12345678901234" root="2.16.840.1.113883.3.4424.2.2.2" displayable="true"/>
            <name>NZOZ „POL-MED”</name>
            <asOrganizationPartOf>
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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                <id extension="1007" root="2.16.840.1.113883.3.4424.2.3.1" displayable="true"/>
                <id extension="123456789" root="2.16.840.1.113883.3.4424.2.2.1" displayable="true"/>
                <name>POL-MED Sp. z o.o.</name>
              </wholeOrganization>
            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
        <extPL:reimbursementRelatedContract moodCode="EVN" classCode="CNTRCT">
          <extPL:id extension="123456" root="2.16.840.1.113883.3.4424.8.6.7"/>
          <extPL:bounding typeCode="PART">
            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <participant typeCode="IND">
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.19"/>
    <associatedEntity classCode="UNDWRT">
      <id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
    </associatedEntity>
  </participant>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznania</title>
          <text>
            <paragraph ID="OBS_1">I10 Nadciśnienie tętnicze</paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="I10" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Nadciśnienie tętnicze (samoistne)"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text>
            <paragraph ID="ENC_1">
               Proszę o przyjęcie na oddział kardiologii w celu wykonania
              <content ID="PROC_1">koronarografii</content>
            </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="4100" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Oddział kardiologiczny"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="88.55" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Koronarografia z użyciem jednego cewnika"/>
                  <text>
                    <reference value="#PROC_1"/>
                  </text>
                </procedure>
              </entryRelationship>
            </encounter>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.39"/>
          <title>Załączniki</title>
          <text>
            <list>
              <item ID="EXTDOC_1">Wynik badania laboratoryjnego z dnia 01.10.2014</item>
              <item ID="EXTDOC_2">Wynik badania echokardiograficznego z dnia 09.09.2014</item>
            </list>
          </text>
          <entry>
            <organizer classCode="CLUSTER" moodCode="EVN">
              <templateId root="2.16.840.1.113883.3.4424.13.10.4.31"/>
              <statusCode code="completed"/>
              <reference typeCode="REFR">
                <templateId root="2.16.840.1.113883.3.4424.13.10.4.32"/>
                <seperatableInd value="false"/>
                <externalDocument>
                  <templateId root="2.16.840.1.113883.3.4424.13.10.4.33"/>
                  <id extension="2345678" root="2.16.840.1.113883.3.4424.2.7.0.7.1" displayable="false"/>
                  <code code="11502-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Laboratory report">
                    <translation code="06.10" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1" displayName="Wyniki badań laboratoryjnych"/>
                  </code>
                  <text>
                    <reference value="#EXTDOC_2"/>
                  </text>
                  <setId extension="432231" root="2.16.840.1.113883.3.4424.2.7.0.7.2"/>
                  <versionNumber value="1"/>
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              </reference>
              <reference typeCode="REFR">
                <templateId root="2.16.840.1.113883.3.4424.13.10.4.32"/>
                <seperatableInd value="false"/>
                <externalDocument>
                  <templateId root="2.16.840.1.113883.3.4424.13.10.4.34"/>
                  <text>
                    <reference value="#EXTDOC_2"/>
                  </text>
                </externalDocument>
              </reference>
            </organizer>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

Skierowanie na rehabilitację kardiologiczną [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie na rehabilitację kardiologiczną -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="2345678" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57832-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescription for diagnostic or specialist care Document">
    <translation code="02.10" displayName="Skierowanie na badanie lub leczenie" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1"/>
  </code>
  <title>Skierowanie na rehabilitację kardiologiczną</title>
  <effectiveTime value="20130412"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="432231" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="12345" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="62091599999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>01-134</postalCode>
        <streetName>Odkryta</streetName>
        <houseNumber>41</houseNumber>
        <unitID>12</unitID>
      </addr>
      <patient>
        <name>
          <given>Jan</given>
          <given>Franciszek</given>
          <family>Kowalski</family>
        </name>
        <birthTime value="19620915"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20130412"/>
    <assignedAuthor>
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id root="2.16.840.1.113883.3.4424" assigningAuthorityName="CSIOZ" displayable="false"/>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <legalAuthenticator>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.6"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.27"/>
    <time value="20130412"/>
    <signatureCode code="S"/>
    <assignedEntity xsi:type="extPL:AssignedEntity">
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="true"/>
      <code code="LEK" codeSystem="2.16.840.1.113883.3.4424.11.3.18" displayName="Lekarz"/>
      <assignedPerson xsi:type="extPL:Person">
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>lek.</prefix>
          <given>Piotr</given>
          <family>Nowak</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0718" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="neurologia"/>
        </extPL:qualifiedEntity>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
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        <id extension="1007-01" root="2.16.840.1.113883.3.4424.2.3.2" displayable="true"/>
        <name>Poradnia POZ</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <telecom use="PUB" value="fax:22-1111100"/>
        <addr>
          <postalCode>00-950</postalCode>
          <city>Warszawa</city>
          <streetName>Marszałkowska</streetName>
          <houseNumber>320</houseNumber>
        </addr>
        <asOrganizationPartOf>
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.16"/>
            <id extension="12345678901234" root="2.16.840.1.113883.3.4424.2.2.2" displayable="true"/>
            <name>NZOZ „POL-MED”</name>
            <asOrganizationPartOf>
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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                <id extension="123456789" root="2.16.840.1.113883.3.4424.2.2.1" displayable="true"/>
                <name>POL-MED Sp. z o.o.</name>
              </wholeOrganization>
            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
        <extPL:reimbursementRelatedContract moodCode="EVN" classCode="CNTRCT">
          <extPL:id extension="123456" root="2.16.840.1.113883.3.4424.8.6.7"/>
          <extPL:bounding typeCode="PART">
            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznania</title>
          <text>
            <paragraph>
              <content ID="OBS_1">I25.2 Przebyty zawał mięśnia sercowego ściany przedniej</content>
              <content ID="OBS_2">I10 Nadciśnienie tętnicze</content>
            </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="I25.2" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Stary (przebyty) zawał serca"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.2"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="85097005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Secondary diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="I10" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Samoistne (pierwotne) nadciśnienie"/>
                  <text>
                    <reference value="#OBS_2"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text>
            <paragraph ID="ENC_1">Proszę o rehabilitację kardiologiczną u pacjenta po przebytym zawale ściany przedniej serca w styczniu br.</paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="2300" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Dzienny ośrodek rehabilitacji kardiologicznej"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

Skierowanie na gastroskopię [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie na gastroskopię -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="1112223" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57832-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescription for diagnostic or specialist care Document">
    <translation code="02.10" displayName="Skierowanie na badanie lub leczenie" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1"/>
  </code>
  <title>Skierowanie na badanie endoskopowe</title>
  <effectiveTime value="20141001"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="44444332" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="12345" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="72020299999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>01-926</postalCode>
        <streetName>Kwitnąca</streetName>
        <houseNumber>6a</houseNumber>
      </addr>
      <patient>
        <name>
          <given>Józef</given>
          <family>Wojewódzki</family>
        </name>
        <birthTime value="19720202"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20141001"/>
    <assignedAuthor>
      <id extension="2355888" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id root="2.16.840.1.113883.3.4424" assigningAuthorityName="CSIOZ" displayable="false"/>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <legalAuthenticator>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.6"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.27"/>
    <time value="20141001"/>
    <signatureCode code="S"/>
    <assignedEntity xsi:type="extPL:AssignedEntity">
      <id extension="2355888" root="2.16.840.1.113883.3.4424.1.6.2" displayable="true"/>
      <code code="LEK" codeSystem="2.16.840.1.113883.3.4424.11.3.18" displayName="Lekarz"/>
      <assignedPerson xsi:type="extPL:Person">
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>dr n. med.</prefix>
          <given>Marian</given>
          <family>Walewski</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0743" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="gastroenterologia"/>
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      </assignedPerson>
      <representedOrganization>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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        <id extension="1007-01" root="2.16.840.1.113883.3.4424.2.3.2" displayable="true"/>
        <name>Poradnia POZ</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <telecom use="PUB" value="fax:22-1111100"/>
        <addr>
          <postalCode>00-950</postalCode>
          <city>Warszawa</city>
          <streetName>Marszałkowska</streetName>
          <houseNumber>320</houseNumber>
        </addr>
        <asOrganizationPartOf>
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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            <id extension="12345678901234" root="2.16.840.1.113883.3.4424.2.2.2" displayable="true"/>
            <name>NZOZ „POL-MED”</name>
            <asOrganizationPartOf>
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.14"/>
                <id extension="1007" root="2.16.840.1.113883.3.4424.2.3.1" displayable="true"/>
                <id extension="123456789" root="2.16.840.1.113883.3.4424.2.2.1" displayable="true"/>
                <name>POL-MED Sp. z o.o.</name>
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            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
        <extPL:reimbursementRelatedContract moodCode="EVN" classCode="CNTRCT">
          <extPL:id extension="123456" root="2.16.840.1.113883.3.4424.8.6.7"/>
          <extPL:bounding typeCode="PART">
            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <participant typeCode="IND">
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.19"/>
    <associatedEntity classCode="UNDWRT">
      <id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
    </associatedEntity>
  </participant>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznanie</title>
          <text>
            <paragraph>
              <content ID="OBS_1">D50.0 Niedokrwistość z niedoboru żelaza</content>
            </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="D50.0" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Niedokrwistość z niedoboru żelaza spowodowana (przewlekłą) utratą krwi"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text ID="ENC_1">
            <paragraph>
              <caption>Rodzaj badania: </caption>
              <content ID="PROC_1">Gastroskopia</content>
            </paragraph>
            <paragraph>
              <caption>Cel badania (uzasadnienie): </caption>
               Diagnostyka przyczyny niedokrwistości.             </paragraph>
            <paragraph>
              <caption>Badania dotychczas wykonane: </caption>
               Lorem ipsum dolor sit amet, consectetur adipiscing elit. Quisque sed urna nibh. Donec lacus mi, varius sed ex at, elementum mattis mauris. In sit amet quam vel sem pellentesque euismod.             </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="7910" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Pracownia endoskopii"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="44.16" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Gastroskopia diagnostyczna"/>
                  <text>
                    <reference value="#PROC_1"/>
                  </text>
                </procedure>
              </entryRelationship>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

Skierowanie do poradni neurologicznej [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie do poradni neurologicznej -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="99999" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57133-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Referral note">
    <translation code="02.11" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1" displayName="Skierowanie na konsultację"/>
  </code>
  <title>Skierowanie do poradni specjalistycznej</title>
  <effectiveTime value="20141010"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="88888" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="123456" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="42101099999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>01–809</postalCode>
        <streetName>Cegłowska</streetName>
        <houseNumber>80</houseNumber>
      </addr>
      <patient>
        <name>
          <given>Adrian</given>
          <given>Wiktor</given>
          <family>Cebulski</family>
        </name>
        <birthTime value="19421010"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20141010"/>
    <assignedAuthor>
      <id extension="2355000" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id root="2.16.840.1.113883.3.4424" assigningAuthorityName="CSIOZ" displayable="false"/>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <legalAuthenticator>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.6"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.27"/>
    <time value="20141010"/>
    <signatureCode code="S"/>
    <assignedEntity xsi:type="extPL:AssignedEntity">
      <id extension="2355000" root="2.16.840.1.113883.3.4424.1.6.2" displayable="true"/>
      <code code="LEK" codeSystem="2.16.840.1.113883.3.4424.11.3.18" displayName="Lekarz"/>
      <assignedPerson xsi:type="extPL:Person">
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>lek.</prefix>
          <given>Adam</given>
          <family>Zadrożny</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0705" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="choroby wewnętrzne"/>
        </extPL:qualifiedEntity>
      </assignedPerson>
      <representedOrganization>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.18"/>
        <id extension="031-000000008610" root="2.16.840.1.113883.3.4424.2.3.3"/>
        <name>Ambulatorium Ogólne</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <addr>
          <postalCode>03-589</postalCode>
          <city>Warszawa</city>
          <streetName>Gilarska</streetName>
          <houseNumber>86c</houseNumber>
        </addr>
        <asOrganizationPartOf classCode="PART">
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.17"/>
            <id extension="01-000000008610" root="2.16.840.1.113883.3.4424.2.3.2"/>
            <name>Oddział Zacisze</name>
            <asOrganizationPartOf classCode="PART">
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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                <id extension="14080268500021" root="2.16.840.1.113883.3.4424.2.2.2"/>
                <name>Centrum Medyczne ENEL-MED - AMBULATORIUM</name>
                <asOrganizationPartOf classCode="PART">
                  <wholeOrganization>
                    <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
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                    <id extension="000000008610" root="2.16.840.1.113883.3.4424.2.3.1"/>
                    <name>Centrum Medyczne ENEL-MED Spółka Akcyjna</name>
                  </wholeOrganization>
                </asOrganizationPartOf>
              </wholeOrganization>
            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
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            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <participant typeCode="IND">
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.19"/>
    <associatedEntity classCode="UNDWRT">
      <id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
    </associatedEntity>
  </participant>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznanie</title>
          <text>
            <paragraph>
              <content ID="OBS_1">G54.4 Dyskopatia odcinka lędźwiowo-krzyżowego kręgosłupa na poziomie L5/S1</content>
            </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="G54.4" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Zaburzenia korzeni nerwów rdzeniowych lędźwiowo-krzyżowych niesklasyfikowanych gdzie indziej"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text ID="ENC_1">
            <paragraph> Proszę o poradę specjalistyczną. </paragraph>
            <paragraph>
              <caption>Nazwa poradni: </caption>
               Poradnia neurologiczna             </paragraph>
            <paragraph>
              <caption>Cel porady (uzasadnienie): </caption>
               Od trzech tygodni narastający ból okolicy lędźwiowo-krzyżowej kręgosłupa z promieniowaniem do prawej kończyny dolnej. Opadnięcie stopy prawej. Parestezje prawej kończyny dolnej.             </paragraph>
            <paragraph>
              <caption>Badania dotychczas wykonane: </caption>
               W badaniu rezonansu magnetycznego odcinka L-S kręgosłupa centralno-prawoboczna przepuklina krążka międzykręgowego na poziomie L5/S1 zwężającq zachyłek boczny po stronie prawej z kompresją korzenia nerwowego.             </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="1220" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Poradnia neurologiczna"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

Skierowanie na rehabilitację poudarową [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie na rehabilitację -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="11223344" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57832-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescription for diagnostic or specialist care Document">
    <translation code="02.10" displayName="Skierowanie na badanie lub leczenie" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1"/>
  </code>
  <title>Skierowanie na rehabilitację</title>
  <effectiveTime value="20141012"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="443322" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="123456" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="32101099999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>03–134</postalCode>
        <streetName>Książkowa 8d</streetName>
        <houseNumber>89</houseNumber>
      </addr>
      <patient>
        <name>
          <given>Adrian</given>
          <family>Kowalski</family>
        </name>
        <birthTime value="19321010"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20141012"/>
    <assignedAuthor>
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id root="2.16.840.1.113883.3.4424" assigningAuthorityName="CSIOZ" displayable="false"/>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <legalAuthenticator>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.6"/>
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    <time value="20141012"/>
    <signatureCode code="S"/>
    <assignedEntity xsi:type="extPL:AssignedEntity">
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="true"/>
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      <assignedPerson xsi:type="extPL:Person">
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>lek.</prefix>
          <given>Piotr</given>
          <family>Nowak</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0718" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="neurologia"/>
        </extPL:qualifiedEntity>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0726" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="radiologia i diagnostyka obrazowa"/>
        </extPL:qualifiedEntity>
      </assignedPerson>
      <representedOrganization>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.17"/>
        <id extension="1007-01" root="2.16.840.1.113883.3.4424.2.3.2" displayable="true"/>
        <name>Poradnia POZ</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <telecom use="PUB" value="fax:22-1111100"/>
        <addr>
          <postalCode>00-950</postalCode>
          <city>Warszawa</city>
          <streetName>Marszałkowska</streetName>
          <houseNumber>320</houseNumber>
        </addr>
        <asOrganizationPartOf>
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.16"/>
            <id extension="12345678901234" root="2.16.840.1.113883.3.4424.2.2.2" displayable="true"/>
            <name>NZOZ „POL-MED”</name>
            <asOrganizationPartOf>
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.14"/>
                <id extension="1007" root="2.16.840.1.113883.3.4424.2.3.1" displayable="true"/>
                <id extension="123456789" root="2.16.840.1.113883.3.4424.2.2.1" displayable="true"/>
                <name>POL-MED Sp. z o.o.</name>
              </wholeOrganization>
            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
        <extPL:reimbursementRelatedContract moodCode="EVN" classCode="CNTRCT">
          <extPL:id extension="654321" root="2.16.840.1.113883.3.4424.8.6.7"/>
          <extPL:bounding typeCode="PART">
            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <participant typeCode="IND">
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.19"/>
    <associatedEntity classCode="UNDWRT">
      <id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
    </associatedEntity>
  </participant>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznanie</title>
          <text>
            <paragraph>
              <content ID="OBS_1">I69.3 Przebyty udar niedokrwienny mózgu pod postacią zespołu piramidowego prawostronnego</content>
            </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="I69.3" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Następstwa zawału mózgu"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text ID="ENC_1">
            <paragraph>
              <caption>Cel porady (uzasadnienie): </caption>
               Proszę o kwalifikację do rehabilitacji poudarowej w warunkach domowych. Przebyty udar niedokrwienny mózgu pod postacią niedowładu piramidowego prawostronnego.             </paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="1300" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Poradnia rehabilitacyja"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

Skierowanie do laboratorium [Pokaż przykład]

<ClinicalDocument>
  <!-- Skierowanie do laboratorium -->
  <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.1"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.2"/>
  <templateId root="2.16.840.1.113883.3.4424.13.10.1.4" extension="1.2"/>
  <id extension="654321" root="2.16.840.1.113883.3.4424.7.4.1" displayable="false"/>
  <code code="57832-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescription for diagnostic or specialist care Document">
    <translation code="02.10" displayName="Skierowanie na badanie lub leczenie" codeSystem="2.16.840.1.113883.3.4424.11.1.32" codeSystemName="KLAS_DOK_P1"/>
  </code>
  <title>Skierowanie do laboratorium</title>
  <effectiveTime value="20130412"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
  <languageCode code="pl-PL"/>
  <setId extension="123456" root="2.16.840.1.113883.3.4424.7.4.2"/>
  <versionNumber value="1"/>
  <recordTarget>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.3"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.26"/>
    <patientRole>
      <id extension="12345" root="2.16.840.1.113883.3.4424.2.7.0.17.1" displayable="false"/>
      <id extension="62011699999" root="2.16.840.1.113883.3.4424.1.1.616" displayable="true"/>
      <addr>
        <city>Warszawa</city>
        <postalCode>01-134</postalCode>
        <streetName>Odkryta</streetName>
        <houseNumber>41</houseNumber>
        <unitID>12</unitID>
      </addr>
      <patient>
        <name>
          <given>Jan</given>
          <given>Franciszek</given>
          <family>Kowalski</family>
        </name>
        <birthTime value="19620116"/>
      </patient>
    </patientRole>
  </recordTarget>
  <author>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.4"/>
    <time value="20130412"/>
    <assignedAuthor>
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="false"/>
    </assignedAuthor>
  </author>
  <custodian>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.5"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.20"/>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id root="2.16.840.1.113883.3.4424" assigningAuthorityName="CSIOZ" displayable="false"/>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <legalAuthenticator>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.6"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.27"/>
    <time value="20130412"/>
    <signatureCode code="S"/>
    <assignedEntity xsi:type="extPL:AssignedEntity">
      <id extension="7724513" root="2.16.840.1.113883.3.4424.1.6.2" displayable="true"/>
      <code code="LEK" codeSystem="2.16.840.1.113883.3.4424.11.3.18" displayName="Lekarz"/>
      <assignedPerson xsi:type="extPL:Person">
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.1"/>
        <name>
          <prefix>lek.</prefix>
          <given>Piotr</given>
          <family>Nowak</family>
        </name>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0718" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="neurologia"/>
        </extPL:qualifiedEntity>
        <extPL:qualifiedEntity classCode="QUAL">
          <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.10"/>
          <extPL:code code="0726" codeSystem="2.16.840.1.113883.3.4424.11.3.3" displayName="radiologia i diagnostyka obrazowa"/>
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      </assignedPerson>
      <representedOrganization>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
        <templateId root="2.16.840.1.113883.3.4424.13.10.2.17"/>
        <id extension="1007-01" root="2.16.840.1.113883.3.4424.2.3.2" displayable="true"/>
        <name>Poradnia POZ</name>
        <telecom use="PUB" value="tel:22-1111123"/>
        <telecom use="PUB" value="fax:22-1111100"/>
        <addr>
          <postalCode>00-950</postalCode>
          <city>Warszawa</city>
          <streetName>Marszałkowska</streetName>
          <houseNumber>320</houseNumber>
        </addr>
        <asOrganizationPartOf>
          <wholeOrganization>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
            <templateId root="2.16.840.1.113883.3.4424.13.10.2.16"/>
            <id extension="12345678901234" root="2.16.840.1.113883.3.4424.2.2.2" displayable="true"/>
            <name>NZOZ „POL-MED”</name>
            <asOrganizationPartOf>
              <wholeOrganization>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.2"/>
                <templateId root="2.16.840.1.113883.3.4424.13.10.2.14"/>
                <id extension="1007" root="2.16.840.1.113883.3.4424.2.3.1" displayable="true"/>
                <id extension="123456789" root="2.16.840.1.113883.3.4424.2.2.1" displayable="true"/>
                <name>POL-MED Sp. z o.o.</name>
              </wholeOrganization>
            </asOrganizationPartOf>
          </wholeOrganization>
        </asOrganizationPartOf>
      </representedOrganization>
      <extPL:boundedBy typeCode="PART">
        <extPL:templateId root="2.16.840.1.113883.3.4424.13.10.2.44"/>
        <extPL:reimbursementRelatedContract moodCode="EVN" classCode="CNTRCT">
          <extPL:id extension="123456" root="2.16.840.1.113883.3.4424.8.6.7"/>
          <extPL:bounding typeCode="PART">
            <extPL:reimburser classCode="UNDWRT">
              <extPL:id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="true"/>
            </extPL:reimburser>
          </extPL:bounding>
        </extPL:reimbursementRelatedContract>
      </extPL:boundedBy>
    </assignedEntity>
  </legalAuthenticator>
  <participant typeCode="IND">
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.19"/>
    <associatedEntity classCode="UNDWRT">
      <id extension="07" root="2.16.840.1.113883.3.4424.3.1" displayable="false"/>
    </associatedEntity>
  </participant>
  <component>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.8"/>
    <templateId root="2.16.840.1.113883.3.4424.13.10.2.28"/>
    <structuredBody>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.1"/>
          <code code="29548-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Diagnosis"/>
          <title>Rozpoznania</title>
          <text>
            <paragraph ID="OBS_1">I10 Nadciśnienie tętnicze</paragraph>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.1"/>
            <organizer classCode="BATTERY" moodCode="EVN">
              <code code="8319008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Principal diagnosis"/>
              <statusCode code="completed"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <code code="I10" codeSystem="2.16.840.1.113883.6.3" codeSystemName="icd10" displayName="Nadciśnienie tętnicze (samoistne)"/>
                  <text>
                    <reference value="#OBS_1"/>
                  </text>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.3.4424.13.10.3.6"/>
          <code code="57828-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Prescriptions"/>
          <text>
            <list ID="ENC_1">
              <caption>Proszę o wykonanie następujących badań:</caption>
              <item ID="PROC_1">Morfologia krwi</item>
              <item ID="PROC_2">Sód (Na)</item>
              <item ID="PROC_3">Potas (K)</item>
              <item ID="PROC_4">Kreatynina</item>
              <item ID="PROC_5">Mocznik</item>
            </list>
          </text>
          <entry>
            <templateId root="2.16.840.1.113883.3.4424.13.10.4.6"/>
            <encounter classCode="ENC" moodCode="RQO">
              <code code="7100" codeSystem="2.16.840.1.113883.3.4424.11.2.4" displayName="Pracownia diagnostyki laboratoryjnej (laboratorium)"/>
              <text>
                <reference value="#ENC_1"/>
              </text>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="C53" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Morfologia krwi 8-parametrowa"/>
                  <text>
                    <reference value="#PROC_1"/>
                  </text>
                </procedure>
              </entryRelationship>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="O35" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Sód (Na)"/>
                  <text>
                    <reference value="#PROC_2"/>
                  </text>
                </procedure>
              </entryRelationship>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="N45" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Potas (K)"/>
                  <text>
                    <reference value="#PROC_3"/>
                  </text>
                </procedure>
              </entryRelationship>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="M37" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Kreatynina"/>
                  <text>
                    <reference value="#PROC_4"/>
                  </text>
                </procedure>
              </entryRelationship>
              <entryRelationship typeCode="COMP">
                <procedure classCode="PROC" moodCode="RQO">
                  <code code="N13" codeSystem="2.16.840.1.113883.3.4424.11.2.6" codeSystemName="ICD-9-PL" displayName="Mocznik"/>
                  <text>
                    <reference value="#PROC_5"/>
                  </text>
                </procedure>
              </entryRelationship>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>