---
type: "example"
title: "QuestionnaireResponse Example: questionnaireresponse-example-bluebook"
resource: "QuestionnaireResponse"
example: "questionnaireresponse-example-bluebook"
---
# QuestionnaireResponse Example: questionnaireresponse-example-bluebook

## Narrative

Cathy Jones, female. Birth weight 3.25 kg at 44.3 cm. 
        Injection of Vitamin K given on 1972-11-30 (first dose) and 1972-12-11 (second dose)
        Note: Was able to speak Chinese at birth.

## Example XML



```xml
<QuestionnaireResponse xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../publish/questionnaireresponse.xsd">
  <!-- Please not that in this questionnaire, the questions are mostly unnamed, that is, the questions are not identified using the <name> element. It will therefore
    be hard to extract useful information in an automated way from this questionnaire. This is, however, quite often the case when modeling existing questionnaires -->
  <id value="bb"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <pre>
        Cathy Jones, female. Birth weight 3.25 kg at 44.3 cm. 
        Injection of Vitamin K given on 1972-11-30 (first dose) and 1972-12-11 (second dose)
        Note: Was able to speak Chinese at birth.
      </pre>
    </div>
  </text>
  <questionnaire value="http://hl7.org/fhir/Questionnaire/bb"/>
  <status value="completed"/>
  <subject>
    <reference value="http://hl7.org/fhir/Patient/1"/>
    <type value="Patient"/>
  </subject>
  <authored value="2013-02-19T14:15:00+10:00"/>
  <author>
    <reference value="http://hl7.org/fhir/Practitioner/example"/>
    <type value="Practitioner"/>
  </author>
    <!-- Many groups left out of this example -->
  <item>
    <linkId value="birthDetails"/>
    <text value="Birth details - To be completed by health professional"/>
    <item>
	  <linkId value="group"/>
      <item>
        <linkId value="nameOfChild"/>
        <text value="Name of child"/>
        <answer>
          <valueString value="Cathy Jones"/>
        </answer>
      </item>
      <item>
        <linkId value="sex"/>
        <text value="Sex"/>
        <answer>
          <valueCoding>
            <code value="F"/>
          </valueCoding>
        </answer>
      </item>
    </item>
    <item>
      <linkId value="neonatalInformation"/>
      <text value="Neonatal Information"/>
      <item>
        <linkId value="birthWeight"/>
        <text value="Birth weight (kg)"/>
        <answer>
          <valueDecimal value="3.25"/>
        </answer>
      </item>
      <item>
        <linkId value="birthLength"/>
        <text value="Birth length (cm)"/>
        <answer>
          <valueDecimal value="44.3"/>
        </answer>
      </item>
      <item>
        <linkId value="vitaminKgiven"/>
        <text value="Vitamin K given"/>
        <answer>
          <valueCoding>
            <code value="INJECTION"/>
          </valueCoding>
          <item>
            <linkId value="vitaminKgivenDoses"/>
            <item>
              <linkId value="vitaminKDose1"/>
              <text value="1st dose"/>
              <answer>
                <valueDateTime value="1972-11-30"/>
              </answer>
            </item>
            <item>
              <linkId value="vitaminKDose2"/>
              <text value="2nd dose"/>
              <answer>
                <valueDateTime value="1972-12-11"/>
              </answer>
            </item>
          </item>
        </answer>
      </item>
      <item>
        <linkId value="hepBgiven"/>
        <text value="Hep B given y / n"/>
        <answer>
          <valueBoolean value="true"/>
          <item>
            <linkId value="hepBgivenDate"/>
            <text value="Date given"/>
            <answer>
              <valueDate value="1972-12-04"/>
            </answer>
          </item>
        </answer>
      </item>
      <item>
        <linkId value="abnormalitiesAtBirth"/>
        <text value="Abnormalities noted at birth"/>
        <answer>
          <valueString value="Already able to speak Chinese"/>
        </answer>
      </item>
    </item>
  </item>
</QuestionnaireResponse>
```