<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type='text/xsl' href='http://researchservice.greenwaymedical.com/stylesheets/ccd.xsl'?>
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
    xmlns:voc="urn:hl7-org:v3/voc" xmlns="urn:hl7-org:v3">
    <realmCode code="US"/>
    <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
    <templateId root="2.16.840.1.113883.10.20.22.1.1"/>
    <templateId root="2.16.840.1.113883.10.20.22.1.2"/>
    <id root="2.16.840.1.113883.3.441" extension="75fdbb4a68d749d98cd42993bd48f8a5"/>
    <code code="34133-9" displayName="Summarization of episode note"
        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
    <title>MU2 Clinical Visit Summary</title>
    <effectiveTime value="20130701110831-0400"/>
    <confidentialityCode code="N" displayName="Normal" codeSystem="2.16.840.1.113883.5.25"
        codeSystemName="Confidentiality"/>
    <languageCode code="en-US"/>
    <setId root="2.16.840.1.113883.3.441" extension="1"/>
    <versionNumber value="1"/>
    <recordTarget typeCode="RCT" contextControlCode="OP">
        <patientRole classCode="PAT">
            <id root="2.16.840.1.113883.3.441.1.50.300011.51" extension="26840"/>
            <addr>
                <streetAddressLine>123 Test Ave</streetAddressLine>
                <streetAddressLine nullFlavor="UNK"/>
                <city>Norcross</city>
                <state>GA</state>
                <postalCode>30091</postalCode>
                <country>US</country>
            </addr>
            <telecom use="HP" nullFlavor="UNK"/>
            <patient classCode="PSN" determinerCode="INSTANCE">
                <name>
                    <given>Three</given>
                    <family>ClinicalSummary</family>
                </name>
                <administrativeGenderCode code="F" displayName="Female"
                    codeSystem="2.16.840.1.113883.5.1" codeSystemName="Administrative Gender Code"/>
                <birthTime value="19480409"/>
                <maritalStatusCode code="D" displayName="Divorced"
                    codeSystem="2.16.840.1.113883.5.2"
                    codeSystemName="HL7v3 Marital Status Value Set"/>
                <raceCode code="2106-3" displayName="White" codeSystem="2.16.840.1.113883.6.238"
                    codeSystemName="CDC Race Code Value Set"/>
                <ethnicGroupCode code="2135-2" displayName="Hispanic or Latino"
                    codeSystem="2.16.840.1.113883.6.238"
                    codeSystemName="OMB Standards for Race and Ethnicity"/>
                <languageCommunication>
                    <languageCode code="isl"/>
                </languageCommunication>
            </patient>
            <providerOrganization classCode="ORG" determinerCode="INSTANCE">
                <id root="2.16.840.1.113883.3.441.1.50" extension="300011"/>
                <name>Cassie's OB/GYN Clinic</name>
                <telecom use="WP" value="555-555-1004"/>
                <addr>
                    <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                    <streetAddressLine nullFlavor="UNK"/>
                    <city>Portland</city>
                    <state>OR</state>
                    <postalCode>97005</postalCode>
                    <country>United States</country>
                </addr>
            </providerOrganization>
        </patientRole>
    </recordTarget>
    <author typeCode="AUT" contextControlCode="OP">
        <time nullFlavor="UNK"/>
        <assignedAuthor classCode="ASSIGNED">
            <id root="2.16.840.1.113883.4.6" extension="be5c297fad17426eb08eee2549a9b741"/>
            <addr>
                <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                <streetAddressLine nullFlavor="UNK"/>
                <city>Portland</city>
                <state>OR</state>
                <postalCode>97005</postalCode>
                <country>United States</country>
            </addr>
            <telecom use="WP" value="555-555-1004"/>
            <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                <name>
                    <given>AD008</given>
                    <family>AD008</family>
                </name>
            </assignedPerson>
            <representedOrganization>
                <id root="2.16.840.1.113883.3.441.1.50" extension="300011"/>
                <name>Cassie's OB/GYN Clinic</name>
                <telecom use="WP" value="555-555-1004"/>
                <addr>
                    <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                    <streetAddressLine nullFlavor="UNK"/>
                    <city>Portland</city>
                    <state>OR</state>
                    <postalCode>97005</postalCode>
                    <country>United States</country>
                </addr>
            </representedOrganization>
        </assignedAuthor>
    </author>
    <informant>
        <assignedEntity>
            <id nullFlavor="NA"/>
            <addr>
                <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                <streetAddressLine nullFlavor="UNK"/>
                <city>Portland</city>
                <state>OR</state>
                <postalCode>97005</postalCode>
                <country>United States</country>
            </addr>
            <telecom use="WP" value="555-555-1004"/>
            <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                <name>
                    <given>AD008</given>
                    <family>AD008</family>
                </name>
            </assignedPerson>
            <representedOrganization>
                <id root="2.16.840.1.113883.3.441.1.50" extension="300011"/>
                <name>Cassie's OB/GYN Clinic</name>
                <telecom use="WP" value="555-555-1004"/>
                <addr>
                    <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                    <streetAddressLine nullFlavor="UNK"/>
                    <city>Portland</city>
                    <state>OR</state>
                    <postalCode>97005</postalCode>
                    <country>United States</country>
                </addr>
            </representedOrganization>
        </assignedEntity>
    </informant>
    <custodian typeCode="CST">
        <assignedCustodian classCode="ASSIGNED">
            <representedCustodianOrganization classCode="ORG" determinerCode="INSTANCE">
                <id root="2.16.840.1.113883.3.441.1.50" extension="300011"/>
                <name>Cassie's OB/GYN Clinic</name>
                <telecom use="WP" value="555-555-1004"/>
                <addr>
                    <streetAddressLine>1004 Healthcare Dr. practice</streetAddressLine>
                    <streetAddressLine nullFlavor="UNK"/>
                    <city>Portland</city>
                    <state>OR</state>
                    <postalCode>97005</postalCode>
                    <country>United States</country>
                </addr>
            </representedCustodianOrganization>
        </assignedCustodian>
    </custodian>
    <legalAuthenticator>
        <time value="20130701110831-0400"/>
        <signatureCode code="S"/>
        <assignedEntity>
            <id root="2.16.840.1.113883.4.6"/>
            <addr>
                <streetAddressLine nullFlavor="UNK"/>
                <streetAddressLine nullFlavor="UNK"/>
                <city nullFlavor="UNK"/>
                <state nullFlavor="UNK"/>
                <postalCode nullFlavor="UNK"/>
                <country>US</country>
            </addr>
            <telecom use="WP" nullFlavor="UNK"/>
            <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                <name>
                    <given>AD008</given>
                    <family>AD008</family>
                </name>
            </assignedPerson>
        </assignedEntity>
    </legalAuthenticator>
    <documentationOf typeCode="DOC">
        <serviceEvent classCode="PCPR" moodCode="EVN">
            <effectiveTime nullFlavor="UNK">
                <low nullFlavor="UNK"/>
                <high nullFlavor="UNK"/>
            </effectiveTime>
            <performer typeCode="PRF">
                <templateId root="2.16.840.1.113883.3.88.11.83.4"/>
                <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
                <functionCode code="PP" displayName="Primary CareProvider"
                    codeSystem="2.16.840.1.113883.12.443" codeSystemName="Provider Role"/>
                <time nullFlavor="UNK">
                    <low nullFlavor="UNK"/>
                    <high nullFlavor="UNK"/>
                </time>
                <assignedEntity>
                    <id root="2.16.840.1.113883.4.6" extension="UNK"/>
                    <addr nullFlavor="UNK"/>
                    <telecom use="WP" nullFlavor="UNK"/>
                    <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                        <name nullFlavor="UNK"/>
                    </assignedPerson>
                </assignedEntity>
            </performer>
            <performer typeCode="PRF">
                <templateId root="2.16.840.1.113883.3.88.11.83.4"/>
                <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
                <assignedEntity>
                    <id root="2.16.840.1.113883.4.6" extension="UNK"/>
                    <code code="-1" displayName="Proctologist" codeSystemName="GMTDynamic"/>
                    <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                        <name>
                            <given>James</given>
                            <family>Ingram, M.D.</family>
                        </name>
                    </assignedPerson>
                </assignedEntity>
            </performer>
            <performer typeCode="PRF">
                <templateId root="2.16.840.1.113883.3.88.11.83.4"/>
                <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
                <assignedEntity>
                    <id root="2.16.840.1.113883.4.6" extension="UNK"/>
                    <code code="-1" displayName="Pain Management" codeSystemName="GMTDynamic"/>
                    <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                        <name>
                            <given>Henry</given>
                            <family>Seven, M.D.</family>
                        </name>
                    </assignedPerson>
                </assignedEntity>
            </performer>
            <performer typeCode="PRF">
                <templateId root="2.16.840.1.113883.3.88.11.83.4"/>
                <templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
                <assignedEntity>
                    <id root="2.16.840.1.113883.4.6" extension="UNK"/>
                    <code code="-1" displayName="Gastroenterologist" codeSystemName="GMTDynamic"/>
                    <assignedPerson classCode="PSN" determinerCode="INSTANCE">
                        <name>
                            <given>Penny</given>
                            <family>Puffer, M.D.</family>
                        </name>
                    </assignedPerson>
                </assignedEntity>
            </performer>
        </serviceEvent>
    </documentationOf>
    <component>
        <structuredBody classCode="DOCBODY" moodCode="EVN">
            <templateId root="2.16.840.1.113883.10" extension="MPL_CDAR2_LEVEL1-2REF_US_I2_2005SEP"/>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.12"/>
                    <id root="2.16.840.1.113883.3.441" extension="2d7bab615e9043db"/>
                    <code code="29299-5" displayName="Reason for Visit"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Reason for Visit</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="2ec5100632464265"/>
                    <code code="48765-2" displayName="Allergies, adverse reactions, alerts"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Allergies and Adverse Reactions</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.4.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="24df5252f7494583"/>
                    <code code="8716-3" displayName="Vital signs" codeSystem="2.16.840.1.113883.6.1"
                        codeSystemName="LOINC"/>
                    <title>Vital Signs</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.38"/>
                    <id root="2.16.840.1.113883.3.441" extension="dd85720684cc4176"/>
                    <code code="29549-3" displayName="Medications Administered"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Medications Administered</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="70c7cc994fe54853"/>
                    <code code="10160-0" displayName="History of medication use"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Medications</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.2.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="dd7fa6c793fa449d"/>
                    <code code="11369-6" displayName="History of immunizations"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>History Of Immunizations</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.7.1"/>
                    <templateId root="2.16.840.1.113883.10.20.22.2.7"/>
                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.53"
                        extension="33c95a786ec04d2c"/>
                    <code code="47519-4" displayName="History of procedures"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>History of Procedures</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Date Ordered</th>
                                    <th>Description</th>
                                    <th>Order Status</th>
                                    <th>Result Status</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_dateOrdered_1"
                                        >3/20/2013 12:00 AM</td>
                                    <td ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_1"
                                        >Lipid panel</td>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_orderStatus_1"
                                        >Ordered</td>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_resultStatus_1"
                                    />
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_dateOrdered_2"
                                        >3/20/2013 12:00 AM</td>
                                    <td ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_2"
                                        >Lipid panel</td>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_orderStatus_2"
                                        >Ordered</td>
                                    <td
                                        ID="ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_resultStatus_2"
                                    />
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.13"/>
                            <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.53"
                                extension="61434"/>
                            <code code="80061" displayName="LIPID PANEL"
                                codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT">
                                <originalText>
                                    <reference
                                        value="#ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_1"
                                    />
                                </originalText>
                            </code>
                            <text>Lipid panel<reference
                                    value="#ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_1"
                                /></text>
                            <statusCode code="completed"/>
                            <effectiveTime value="20130320000000"/>
                            <value xsi:type="CD" nullFlavor="OTH"/>
                        </observation>
                    </entry>
                    <entry>
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.13"/>
                            <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.53"
                                extension="61435"/>
                            <code code="80061" displayName="LIPID PANEL"
                                codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT">
                                <originalText>
                                    <reference
                                        value="#ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_2"
                                    />
                                </originalText>
                            </code>
                            <text>Lipid panel<reference
                                    value="#ref_2170a013ee4f4afebcc4ac2bbfd2bc2a_procedure_name_2"
                                /></text>
                            <statusCode code="completed"/>
                            <effectiveTime value="20130320000000"/>
                            <value xsi:type="CD" nullFlavor="OTH"/>
                        </observation>
                    </entry>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.3.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="4a5822e7229345ed"/>
                    <code code="30954-2"
                        displayName="Relevant diagnostic tests and/or laboratory data"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Results Summary</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.1"/>
                    <id root="2.16.840.1.113883.3.441" extension="4bda4678b00341aa"/>
                    <code code="42349-1" displayName="REASON FOR REFERRAL"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Reason for Referral</title>
                    <text mediaType="text/x-hl7-text+xml">Not available.</text>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.10"/>
                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.72"
                        extension="4874685f9ce24aed"/>
                    <code code="18776-5" displayName="Treatment Plan"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Plan of Treatment</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Planned Activity</th>
                                    <th>Comments</th>
                                    <th>Planned Date</th>
                                    <th>Planned Time</th>
                                    <th>Plan/Goal</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedActivity_1"
                                        >Lipid panel</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedComments_1"/>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedDate_1"
                                        >3/20/2013</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedTime_1"
                                        >12:00 AM</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedGoal_1"
                                    />
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedActivity_2"
                                        >Lipid panel</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedComments_2"/>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedDate_2"
                                        >3/20/2013</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedTime_2"
                                        >12:00 AM</td>
                                    <td
                                        ID="ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedGoal_2"
                                    />
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <procedure classCode="PROC" moodCode="INT" negationInd="false">
                            <templateId root="2.16.840.1.113883.10.20.22.4.41"/>
                            <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.72"
                                extension="61434"/>
                            <code code="80061" displayName="Lipid panel" codeSystem="CPT"
                                codeSystemName="Current Procedural Terminology"/>
                            <text>Lipid panel<reference
                                    value="#ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedActivity_1"
                                /></text>
                            <statusCode code="new"/>
                            <effectiveTime value="20130320"/>
                            <approachSiteCode nullFlavor="NA"/>
                            <targetSiteCode nullFlavor="NA"/>
                        </procedure>
                    </entry>
                    <entry>
                        <procedure classCode="PROC" moodCode="INT" negationInd="false">
                            <templateId root="2.16.840.1.113883.10.20.22.4.41"/>
                            <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.72"
                                extension="61435"/>
                            <code code="80061" displayName="Lipid panel" codeSystem="CPT"
                                codeSystemName="Current Procedural Terminology"/>
                            <text>Lipid panel<reference
                                    value="#ref_bce0f769180a4fb8a54248ec289f1935_planOfTreatment__plannedActivity_2"
                                /></text>
                            <statusCode code="new"/>
                            <effectiveTime value="20130320"/>
                            <approachSiteCode nullFlavor="NA"/>
                            <targetSiteCode nullFlavor="NA"/>
                        </procedure>
                    </entry>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.45"/>
                    <id root="2.16.840.1.113883.3.441.1.50.28061.51.26840.52"
                        extension="ce9f38712e064f1e"/>
                    <code code="69730-0" displayName="Instructions"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Clinical Instructions/Patient Decision Aids</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Instruction</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        ID="ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_1"
                                        >Sitz bath</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_2"
                                        >Use donut </td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_3"
                                        >Ice your butt</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <act classCode="ACT" moodCode="INT">
                            <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
                            <id root="2.16.840.1.113883.3.441.1.50.28061.51.26840.52"
                                extension="5524"/>
                            <code code="409073007" displayName="instruction"
                                codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED"/>
                            <text>Sitz bath<reference
                                    value="#ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_1"
                                /></text>
                            <statusCode code="completed"/>
                        </act>
                    </entry>
                    <entry>
                        <act classCode="ACT" moodCode="INT">
                            <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
                            <id root="2.16.840.1.113883.3.441.1.50.28061.51.26840.52"
                                extension="5524"/>
                            <code code="409073007" displayName="instruction"
                                codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED"/>
                            <text>Use donut <reference
                                    value="#ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_2"
                                /></text>
                            <statusCode code="completed"/>
                        </act>
                    </entry>
                    <entry>
                        <act classCode="ACT" moodCode="INT">
                            <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
                            <id root="2.16.840.1.113883.3.441.1.50.28061.51.26840.52"
                                extension="5524"/>
                            <code code="409073007" displayName="instruction"
                                codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED"/>
                            <text>Ice your butt<reference
                                    value="#ref_b622b63a8d5f49fb90c179f6356ee6a9_instructions__instruction_3"
                                /></text>
                            <statusCode code="completed"/>
                        </act>
                    </entry>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.17"/>
                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.68"
                        extension="42b01df780184d4b"/>
                    <code code="29762-2" displayName="Social history"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Social History</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Name</th>
                                    <th>Status</th>
                                    <th>Comments</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        ID="ref_0a296cfe09064a1ba53dc908f4ad834a_socialHistory_name_1"
                                        >Tobacco</td>
                                    <td
                                        ID="ref_0a296cfe09064a1ba53dc908f4ad834a_socialHistory_status_1"
                                        >Heavy</td>
                                    <td
                                        ID="ref_0a296cfe09064a1ba53dc908f4ad834a_socialHistory_comment_1"
                                        >1 ppd for 30 years </td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.78"/>
                            <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.68"
                                extension="1313"/>
                            <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
                            <text>Tobacco<reference
                                    value="ref_0a296cfe09064a1ba53dc908f4ad834a_socialHistory_name_1"
                                /></text>
                            <statusCode code="completed"/>
                            <effectiveTime>
                                <low value="19000101000000"/>
                            </effectiveTime>
                            <value xsi:type="CD" code="428071000124103"
                                codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"
                                displayName="Heavy tobacco smoker"/>
                            <entryRelationship typeCode="REFR">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.1.56"/>
                                    <code code="33999-4" displayName="Status"
                                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                                    <statusCode code="completed"/>
                                    <value xsi:type="CD" code="55561003"
                                        codeSystem="2.16.840.1.113883.6.96" displayName="active"/>
                                </observation>
                            </entryRelationship>
                        </observation>
                    </entry>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="2.16.840.1.113883.10.20.22.2.5.1"/>
                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                        extension="56ffc04e3f084967"/>
                    <code code="11450-4" displayName="Problem list"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>Problem List</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Description</th>
                                    <th>Status</th>
                                    <th>Onset</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_1"
                                        >Essential hypertension</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_1"
                                        >Active</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_onset_1"
                                        >11/24/1999</td>
                                </tr>
                                <tr>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_2"
                                        >Coronary arteriosclerosis</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_2"
                                        >Active</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_onset_2"
                                        >03/14/2004</td>
                                </tr>
                                <tr>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_3"
                                        >Cardiovascular Disease</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_3"
                                        >Active</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_onset_3"
                                        >01/22/1999</td>
                                </tr>
                                <tr>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_4"
                                        >Anal Spasm</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_4"
                                        >Active</td>
                                    <td ID="ref_f7d18f263b8d4722881d5eee75f497b1_problem_onset_4"
                                        >06/21/1964</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
                            <id root="2.16.840.1.113883.3.441"
                                extension="74e0957fcb2849c4a15713d5a6402b92"/>
                            <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
                            <statusCode code="active"/>
                            <effectiveTime nullFlavor="UNK">
                                <low value="19991124000000"/>
                                <high nullFlavor="UNK"/>
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN" negationInd="false">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                                        extension="1415"/>
                                    <code nullFlavor="NA"/>
                                    <text>Essential hypertension<reference
                                            value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_1"
                                        /></text>
                                    <statusCode code="completed"/>
                                    <effectiveTime nullFlavor="UNK">
                                        <low value="19991124000000"/>
                                        <high nullFlavor="UNK"/>
                                    </effectiveTime>
                                    <value xsi:type="CD" nullFlavor="UNK">
                                        <translation code="59621000"
                                            displayName="Essential hypertension"
                                            codeSystem="2.16.840.1.113883.6.96"
                                            codeSystemName="SNOMED CT">
                                            <originalText>
                                                <reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_1"
                                                />
                                            </originalText>
                                        </translation>
                                    </value>
                                    <entryRelationship typeCode="REFR" inversionInd="false">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"
                                                codeSystemName="SNOMED CT"/>
                                            <text>Active<reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_1"
                                                /></text>
                                            <statusCode code="completed"/>
                                            <value xsi:type="CD" code="55561003"
                                                codeSystem="2.16.840.1.113883.6.96"
                                                codeSystemName="SNOMED CT" displayName="Active"/>
                                        </observation>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry>
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
                            <id root="2.16.840.1.113883.3.441"
                                extension="75c2a915aa54458b82f9f26fcad015af"/>
                            <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
                            <statusCode code="active"/>
                            <effectiveTime nullFlavor="UNK">
                                <low value="20040314000000"/>
                                <high nullFlavor="UNK"/>
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN" negationInd="false">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                                        extension="1416"/>
                                    <code nullFlavor="NA"/>
                                    <text>Coronary arteriosclerosis<reference
                                            value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_2"
                                        /></text>
                                    <statusCode code="completed"/>
                                    <effectiveTime nullFlavor="UNK">
                                        <low value="20040314000000"/>
                                        <high nullFlavor="UNK"/>
                                    </effectiveTime>
                                    <value xsi:type="CD" nullFlavor="UNK">
                                        <translation code="53741008"
                                            displayName="Coronary arteriosclerosis"
                                            codeSystem="2.16.840.1.113883.6.96"
                                            codeSystemName="SNOMED CT">
                                            <originalText>
                                                <reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_2"
                                                />
                                            </originalText>
                                        </translation>
                                    </value>
                                    <entryRelationship typeCode="REFR" inversionInd="false">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"
                                                codeSystemName="SNOMED CT"/>
                                            <text>Active<reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_2"
                                                /></text>
                                            <statusCode code="completed"/>
                                            <value xsi:type="CD" code="55561003"
                                                codeSystem="2.16.840.1.113883.6.96"
                                                codeSystemName="SNOMED CT" displayName="Active"/>
                                        </observation>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry>
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
                            <id root="2.16.840.1.113883.3.441"
                                extension="489f49cb8ee24b57b0714fc7c5f1bc50"/>
                            <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
                            <statusCode code="active"/>
                            <effectiveTime nullFlavor="UNK">
                                <low value="19990122000000"/>
                                <high nullFlavor="UNK"/>
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN" negationInd="false">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                                        extension="1417"/>
                                    <code nullFlavor="NA"/>
                                    <text>Cardiovascular Disease<reference
                                            value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_3"
                                        /></text>
                                    <statusCode code="completed"/>
                                    <effectiveTime nullFlavor="UNK">
                                        <low value="19990122000000"/>
                                        <high nullFlavor="UNK"/>
                                    </effectiveTime>
                                    <value xsi:type="CD" nullFlavor="UNK">
                                        <translation code="49601007"
                                            displayName="Cardiovascular Disease"
                                            codeSystem="2.16.840.1.113883.6.96"
                                            codeSystemName="SNOMED CT">
                                            <originalText>
                                                <reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_3"
                                                />
                                            </originalText>
                                        </translation>
                                    </value>
                                    <entryRelationship typeCode="REFR" inversionInd="false">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"
                                                codeSystemName="SNOMED CT"/>
                                            <text>Active<reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_3"
                                                /></text>
                                            <statusCode code="completed"/>
                                            <value xsi:type="CD" code="55561003"
                                                codeSystem="2.16.840.1.113883.6.96"
                                                codeSystemName="SNOMED CT" displayName="Active"/>
                                        </observation>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry>
                        <act classCode="ACT" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.3"/>
                            <id root="2.16.840.1.113883.3.441"
                                extension="c95340b9d041420d9405a984e5a4dc73"/>
                            <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
                            <statusCode code="active"/>
                            <effectiveTime nullFlavor="UNK">
                                <low value="19640621000000"/>
                                <high nullFlavor="UNK"/>
                            </effectiveTime>
                            <entryRelationship typeCode="SUBJ" inversionInd="false">
                                <observation classCode="OBS" moodCode="EVN" negationInd="false">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                                        extension="1418"/>
                                    <code nullFlavor="NA"/>
                                    <text>Anal Spasm<reference
                                            value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_4"
                                        /></text>
                                    <statusCode code="completed"/>
                                    <effectiveTime nullFlavor="UNK">
                                        <low value="19640621000000"/>
                                        <high nullFlavor="UNK"/>
                                    </effectiveTime>
                                    <value xsi:type="CD" nullFlavor="UNK">
                                        <translation code="17440005" displayName="Anal Spasm"
                                            codeSystem="2.16.840.1.113883.6.96"
                                            codeSystemName="SNOMED CT">
                                            <originalText>
                                                <reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_name_4"
                                                />
                                            </originalText>
                                        </translation>
                                    </value>
                                    <entryRelationship typeCode="REFR" inversionInd="false">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"
                                                codeSystemName="SNOMED CT"/>
                                            <text>Active<reference
                                                  value="#ref_f7d18f263b8d4722881d5eee75f497b1_problem_status_4"
                                                /></text>
                                            <statusCode code="completed"/>
                                            <value xsi:type="CD" code="55561003"
                                                codeSystem="2.16.840.1.113883.6.96"
                                                codeSystemName="SNOMED CT" displayName="Active"/>
                                        </observation>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                </section>
            </component>
            <component>
                <section classCode="DOCSECT" moodCode="EVN">
                    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.4"/>
                    <id root="2.16.840.1.113883.3.441.1.50.300011.51.26840.61"
                        extension="a20f6b4c8538492d"/>
                    <code code="10164-2" displayName="HISTORY OF PRESENT ILLNESS"
                        codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
                    <title>History of Present Illness</title>
                    <text mediaType="text/x-hl7-text+xml">
                        <table border="1">
                            <thead>
                                <tr>
                                    <th>Diagnosis</th>
                                    <th>Date</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_1"
                                        >Abscess Of Breast Associated With Childbirth</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_1"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_2"
                                        >Atrophy Of Breast</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_2"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_3"
                                        >Fat Necrosis Of Breast</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_3"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_4"
                                        >Fibroadenosis Of Breast</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_4"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_5"
                                        >Fibrocystic Mastopathy</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_5"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_6"
                                        >First Degree Burn of Breast</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_6"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_7"
                                        >Fissure Of Nipple</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_7"
                                        >03/20/2013</td>
                                </tr>
                                <tr>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_diagnosis_8"
                                        >Malignant Neoplasm Of Female Breast</td>
                                    <td
                                        ID="ref_9f2173a9a20b4b7989001f10616bca5e_presentIllness_date_8"
                                        >03/20/2013</td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                </section>
            </component>
        </structuredBody>
    </component>
</ClinicalDocument>
