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              <item ID="medication1">
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                  <value xsi:type="CD" code="416098002" displayName="drug allergy" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
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              <item ID="procedure1">
                <content>No Procedure</content>
              </item>
            </list>
          </text>
          <entry>
            <procedure classCode="PROC" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.14"/>
              <id root="e401f340-7be2-11db-9fe1-0800200c9a66"/>
              <code code="70548" codeSystem="2.16.840.1.113883.6.12" displayName="NI" codeSystemName="CPT4">
                <originalText>
                  <reference value="#procedure1"/>
                </originalText>
              </code>
              <statusCode code="completed"/>
              <effectiveTime>
                <low nullFlavor="UNK"/>
              </effectiveTime>
            </procedure>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.14"/>
          <code code="47420-5" codeSystem="2.16.840.1.113883.6.1"/>
          <title>FUNCTIONAL STATUS</title>
          <text>
            <list listType="ordered">
              <item>
                <content ID="fstref1">No functional stautus active</content>
              </item>
            </list>
          </text>
        </section>
      </component>
      <component>
        <section nullFlavor="NI">
          <templateId root="2.16.840.1.113883.10.20.22.2.2.1"/>
          <code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations"/>
          <title>IMMUNIZATIONS</title>
          <text>
            <list listType="ordered">
              <item>
                <content ID="immunization1">No immunizations visit</content>
              </item>
            </list>
          </text>
        </section>
      </component>
      <component>
        <section nullFlavor="NI">
          <templateId root="2.16.840.1.113883.10.20.22.2.2.1"/>
          <code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations"/>
          <title>IMMUNIZATIONS</title>
          <text>
            <list listType="ordered">
              <item>
                <content ID="immunization1">No immunizations visit</content>
              </item>
            </list>
          </text>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.17"/>
          <code code="29762-2" codeSystem="2.16.840.1.113883.6.1" displayName="Social History" codeSystemName="LOINC"/>
          <title>Social History</title>
          <text>
            <list listType="ordered">
              <caption>Smoking Status</caption>
              <item>
                <content ID="socList1">No social history narration</content>
              </item>
            </list>
          </text>
          <entry>
            <observation classCode="OBS" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.78"/>
              <id extension="78123" root="1.3.6.1.4.1.22812.3.99930.3.4.12"/>
              <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
              <text>
                <reference value="#socList1"/>
              </text>
              <statusCode code="completed"/>
              <effectiveTime>
                <low nullFlavor="UNK"/>
              </effectiveTime>
              <value xsi:type="CD" nullFlavor="UNK" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
            </observation>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.17"/>
          <code code="29762-2" codeSystem="2.16.840.1.113883.6.1" displayName="Social History" codeSystemName="LOINC"/>
          <title>Social History</title>
          <text>
            <list listType="ordered">
              <caption>Smoking Status</caption>
              <item>
                <content ID="socList1">No social history narration</content>
              </item>
            </list>
          </text>
          <entry>
            <observation classCode="OBS" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.78"/>
              <id extension="78123" root="1.3.6.1.4.1.22812.3.99930.3.4.12"/>
              <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
              <text>
                <reference value="#socList1"/>
              </text>
              <statusCode code="completed"/>
              <effectiveTime>
                <low nullFlavor="UNK"/>
              </effectiveTime>
              <value xsi:type="CD" nullFlavor="UNK" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
            </observation>
          </entry>
        </section>
      </component>
      <component>
        <section nullFlavor="NI">
          <templateId root="2.16.840.1.113883.10.20.22.2.4"/>
          <code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Vital Signs"/>
          <title>Vital Signs</title>
          <text>
            <list listType="ordered">
              <item ID="vital1">
                <content>No Vitals</content>
              </item>
            </list>
          </text>
          <entry>
            <organizer classCode="CLUSTER" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.26"/>
              <id root="1bbf0204-3c95-4320-b2a2-41f46eb3b8bf"/>
              <code code="46680005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Vital signs"/>
              <statusCode code="completed"/>
              <effectiveTime nullFlavor="UNK"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.27"/>
                  <id extension="6660219000356" root="1.3.6.1.4.1.22812.3.99930.3.4.6"/>
                  <id extension="6660219000296" root="1.3.6.1.4.1.22812.3.99930.3.4.6"/>
                  <code nullFlavor="UNK"/>
                  <text>
                    <reference value="#vital1"/>
                  </text>
                  <statusCode code="completed"/>
                  <effectiveTime nullFlavor="UNK"/>
                  <value xsi:type="PQ" nullFlavor="UNK"/>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section nullFlavor="NI">
          <templateId root="2.16.840.1.113883.10.20.22.2.4"/>
          <code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Vital Signs"/>
          <title>Vital Signs</title>
          <text>
            <list listType="ordered">
              <item ID="vital1">
                <content>No Vitals</content>
              </item>
            </list>
          </text>
          <entry>
            <organizer classCode="CLUSTER" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.26"/>
              <id root="1bbf0204-3c95-4320-b2a2-41f46eb3b8bf"/>
              <code code="46680005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Vital signs"/>
              <statusCode code="completed"/>
              <effectiveTime nullFlavor="UNK"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.27"/>
                  <id extension="6660219000356" root="1.3.6.1.4.1.22812.3.99930.3.4.6"/>
                  <id extension="6660219000296" root="1.3.6.1.4.1.22812.3.99930.3.4.6"/>
                  <code nullFlavor="UNK"/>
                  <text>
                    <reference value="#vital1"/>
                  </text>
                  <statusCode code="completed"/>
                  <effectiveTime nullFlavor="UNK"/>
                  <value xsi:type="PQ" nullFlavor="UNK"/>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
          <code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Results"/>
          <title>Results</title>
          <text>
            <list listType="ordered">
              <item ID="result1">
                <content>No Results found</content>
              </item>
            </list>
          </text>
          <entry>
            <organizer classCode="BATTERY" moodCode="EVN" nullFlavor="UNK">
              <templateId root="2.16.840.1.113883.10.20.22.4.1"/>
              <id extension="659988700005" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
              <code xsi:type="CE" nullFlavor="UNK"/>
              <statusCode nullFlavor="UNK"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
                  <id extension="659988700003" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
                  <id extension="659988900003" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
                  <code xsi:type="CE" nullFlavor="UNK" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                  <text>
                    <reference value="#result1"/>
                  </text>
                  <statusCode nullFlavor="UNK"/>
                  <effectiveTime nullFlavor="UNK"/>
                  <value xsi:type="PQ" nullFlavor="UNK"/>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
          <code code="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Results"/>
          <title>Results</title>
          <text>
            <list listType="ordered">
              <item ID="result1">
                <content>No Results found</content>
              </item>
            </list>
          </text>
          <entry>
            <organizer classCode="BATTERY" moodCode="EVN" nullFlavor="UNK">
              <templateId root="2.16.840.1.113883.10.20.22.4.1"/>
              <id extension="659988700005" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
              <code xsi:type="CE" nullFlavor="UNK"/>
              <statusCode nullFlavor="UNK"/>
              <component>
                <observation classCode="OBS" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.2"/>
                  <id extension="659988700003" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
                  <id extension="659988900003" root="1.3.6.1.4.1.22812.3.99930.3.4.5"/>
                  <code xsi:type="CE" nullFlavor="UNK" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                  <text>
                    <reference value="#result1"/>
                  </text>
                  <statusCode nullFlavor="UNK"/>
                  <effectiveTime nullFlavor="UNK"/>
                  <value xsi:type="PQ" nullFlavor="UNK"/>
                </observation>
              </component>
            </organizer>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.10"/>
          <code code="18776-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Plan of Care"/>
          <title>Plan of Care</title>
          <text>
            <list listType="ordered">
              <caption>Planned Acts</caption>
              <item ID="act1">
                <content>No Planned Acts</content>
              </item>
            </list>
            <list listType="ordered">
              <caption>Planned Observation</caption>
              <item ID="obs1">
                <content>No Planned Observaton</content>
              </item>
            </list>
            <list listType="unordered">
              <caption>Planned Encounters</caption>
              <item ID="enc1">
                <content>No Results found</content>
              </item>
            </list>
          </text>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.45"/>
          <code code="69730-0" codeSystem="2.16.840.1.113883.6.1" codeSystemVersion="LOINC" displayName="Instructions"/>
          <title>Instructions</title>
          <text>
            <list listType="ordered">
              <item>
                <content ID="instruction0"></content>
              </item>
            </list>
          </text>
          <entry>
            <act classCode="ACT" moodCode="INT">
              <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
              <code xsi:type="CE" code="385827001" codeSystem="2.16.840.1.113883.11.20.9.34" codeSystemName="patientEducationType" displayName="Patient Education"/>
              <text>Patient Education<reference value="#instruction0"/></text>
              <statusCode code="completed"/>
            </act>
          </entry>
        </section>
      </component>
      <component>
        <section>
          <templateId root="2.16.840.1.113883.10.20.22.2.22.1"/>
          <code code="46240-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Encounter Diagnosis"/>
          <title>Encounter Diagnosis</title>
          <text>
            <list listType="ordered">
              <item ID="encounterd0">
                <content>Dermatitis, Contact Unspecified</content>
              </item>
            </list>
          </text>
          <entry typeCode="DRIV">
            <encounter classCode="ENC" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.49"/>
              <id root="2a620155-9d11-439e-92b3-5d9815ff4de8"/>
              <effectiveTime>
                <low value="20210322"/>
              </effectiveTime>
              <entryRelationship typeCode="RSON">
                <observation classCode="OBS" moodCode="EVN">
                  <templateId root="2.16.840.1.113883.10.20.22.4.19"/>
                  <id root="db734647-fc99-424c-a864-7e3cda82e703" extension="52487"/>
                  <code code="404684003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Finding"/>
                  <text>
                    <reference value="#encounterd0"/>
                  </text>
                  <statusCode code="completed"/>
                  <effectiveTime>
                    <low value="20210322"/>
                  </effectiveTime>
                  <value xsi:type="CD" code="" codeSystem="2.16.840.1.113883.6.96" displayName="Dermatitis, Contact Unspecified"/>
                </observation>
              </entryRelationship>
            </encounter>
          </entry>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>
