<ClinicalDocument>
<!-- Wpis do karty uodpornienia - przykład 1 -->
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<title>Wpis do karty uodpornienia</title>
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<addr>
<city>Warszawa</city>
<postalCode>01-134</postalCode>
<streetName>Odkryta</streetName>
<houseNumber>41</houseNumber>
<unitID>12</unitID>
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<patient>
<name>
<given>Jan</given>
<given>Franciszek</given>
<family>Kowalski</family>
</name>
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<given>Anna</given>
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<name>Oddział neurologii</name>
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<city>Warszawa</city>
<streetName>Solec</streetName>
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<section>
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<title>Podanie szczepionki</title>
<text>
<table>
<thead>
<tr>
<th>Rodzaj szczepionki</th>
<th>Data i godzina wykonania szczepienia</th>
<th>Miejsce/droga podania szczepionki</th>
<th>Nazwa szczepionki</th>
<th>Nr serii szczepionki</th>
<th>Osoba wykonująca szczepienie</th>
</tr> </thead>
<tbody>
<tr ID="SBADM_1">
<td>DTaP - 1 dawka przypominająca</td>
<td>2015-09-07 11:25</td>
<td>głęboko domięśniowo</td>
<td>Boostrix 0,5 ml (1 dawka) zawiesina do wstrzykiwań</td>
<td>123456789</td>
<td>Anna Nowak</td>
</tr> </tbody> </table> </text>
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<text>
<reference value="#SBADM_1"/>
</text>
<effectiveTime value="201509071125"/>
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<lotNumberText>123456789</lotNumberText>
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<given>Anna</given>
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