Patient Name MonikaWegmueller Gender female Birthday 10.02.1967 Adress Leidensweg 10 CH - 9876 Specimendorf Contact home - tel:+41.32.685.12.34 Identifier urn:oid:1.2.3.4: 12345678; Author Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Date 01.06.2021 Immunization Administration ID Vaccination Date Vaccine Lot Route Target Doc Date Performer Identifier 7-2-Immunization 15.09.2013 Boostrix (637) 12-34244 20035000: Intramuscular use Diphtheria caused by Corynebacterium diphtheriae (disorder) Tetanus (disorder) Pertussis (disorder) 15.09.2013 Practitioner DetlefDemo (urn:oid:2.51.1.3: 7601000000309; ) Hilfgasse 7 CH - 3456 Hilferswil BE Organization Praxis Demo (urn:oid:2.51.1.3: 7601000007292; ) Hilfgasse 7 CH - 3456 Hilferswil BE urn:oid:2.16.756.5.30.1.147.1.3.1: 12345; 7-3-Immunization 12.08.2014 Boostrix (637) 12-34244 20035000: Intramuscular use Diphtheria caused by Corynebacterium diphtheriae (disorder) Tetanus (disorder) Pertussis (disorder) 12.08.2014 Practitioner DetlefDemo (urn:oid:2.51.1.3: 7601000000309; ) Hilfgasse 7 CH - 3456 Hilferswil BE Organization Praxis Demo (urn:oid:2.51.1.3: 7601000007292; ) Hilfgasse 7 CH - 3456 Hilferswil BE urn:oid:2.16.756.5.30.1.147.1.3.1: 23456; 7-4-Immunization 01.11.2015 Boostrix (637) 12-34244 20035000: Intramuscular use Diphtheria caused by Corynebacterium diphtheriae (disorder) Tetanus (disorder) Pertussis (disorder) 01.11.2015 Practitioner DetlefDemo (urn:oid:2.51.1.3: 7601000000309; ) Hilfgasse 7 CH - 3456 Hilferswil BE Organization Praxis Demo (urn:oid:2.51.1.3: 7601000007292; ) Hilfgasse 7 CH - 3456 Hilferswil BE urn:oid:2.16.756.5.30.1.147.1.3.1: 34567; 7-5-Immunization 05.03.2016 MMR-II (268) 12-34244 20035000: Intramuscular use Measles (disorder) Mumps (disorder) Rubella (disorder) 05.03.2016 Practitioner MaxMuster (urn:oid:2.51.1.3: 7601000000316; ) Mustergasse 99 CH - 9876 Beispielen SG Organization Praxis Muster (urn:oid:2.51.1.3: 7601000000514; ) Mustergasse 99 CH - 9876 Beispielen SG urn:oid:2.16.756.5.30.1.147.1.3.1: 45678; 7-6-Immunization 26.02.2012 HBVAXPRO 40 (545) 12-34244 20035000: Intramuscular use Viral hepatitis type B (disorder) 26.02.2012 Practitioner MaxMuster (urn:oid:2.51.1.3: 7601000000316; ) Mustergasse 99 CH - 9876 Beispielen SG Organization Praxis Muster (urn:oid:2.51.1.3: 7601000000514; ) Mustergasse 99 CH - 9876 Beispielen SG urn:oid:2.16.756.5.30.1.147.1.3.1: 12312; Other Relevant Observations 8-2-Condition Code ANDERE_LEBERERKRANKUNG (114036) Documentation Date 01.04.2019 Documenter Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - 8-3-Condition Code FLEDERMAUSFORSCHER_UND_SCHUETZER (213006) Documentation Date 01.04.2009 Documenter Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - Undergone illnesses for immunization 8-4-Condition Code Measles (disorder) (14189004) Date 30.11.1966 Documentation Date 01.04.1999 Documenter Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - Allergies 11-1-AllergyIntolerance Code Allergy to egg protein (finding) (213020009) Documentation Date 11.07.2004 Documenter Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - 11-2-AllergyIntolerance Code Atopic dermatitis (disorder) (24079001) Documentation Date 11.07.1996 Documenter Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - Lab 9-1-Observation Code Hepatitis B virus surface Ab [Units/volume] in Serum Result 99 [iU]/L Interpretation Positive Date ..1971 Performer Practitioner AllzeitBereit (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen Organization Gruppenpraxis CH (urn:oid:2.51.1.3: 7601888888884; ) Doktorgasse 2 CH - 8888 Musterhausen ZH Identifier - Comments
This is the section containing all immunization entries.
This is the section containing the medical problem entries.
This is the section containing the undergone illnesses for immunization entries.
Allergies and adverse reactions Document
This is the section containing the allergy entries.
This is the section containing the lab entries.