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

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<QuestionnaireResponse xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/questionnaireresponse.xsd">
	<id value="gcs"/>
	<questionnaire value="http://hl7.org/fhir/Questionnaire/gcs"/>
	<status value="completed"/>
	<subject>
		<reference value="Patient/example"/>
		<display value="Peter James Chalmers"/>
	</subject>
	<authored value="2014-12-11T04:44:16Z"/>
	<source>
		<reference value="Practitioner/f007"/>
	</source>
  <item>
    <linkId value="1.1"/>
    <answer>
      <valueCoding>
        <!--   This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--  from Element: extension  -->
          <valueDecimal value="4"/>
          <!--  0..1 Value of extension  -->
        </extension>
        <system value="http://loinc.org"/>
        <!-- technicallly the code is '5' and the LA is the identifier to do hav e both  would require an extention -->
        <code value="LA6560-2"/>
        <display value="Confused"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="1.2"/>
    <answer>
      <valueCoding>
        <!--   This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--  from Element: extension  -->
          <valueDecimal value="5"/>
          <!--  0..1 Value of extension  -->
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6566-9"/>
        <display value="Localizing pain"/>
      </valueCoding>
    </answer>
  </item>
  <item>
    <linkId value="1.3"/>
    <answer>
      <valueCoding>
        <!--   This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--  from Element: extension  -->
          <valueDecimal value="4"/>
          <!--  0..1 Value of extension  -->
        </extension>
        <system value="http://loinc.org"/>
        <!-- technicallly the code is '4' and the LA is the identifier to do hav e both  would require an extention -->
        <code value="LA6556-0"/>
        <display value="Eyes open spontaneously"/>
      </valueCoding>
    </answer>
  </item>
</QuestionnaireResponse>
```