<?xml version="1.0" encoding="UTF-8"?>
<Questionnaire xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
    xsi:schemaLocation="http://hl7.org/fhir ../../schema/questionnaire.xsd">
    <status value="completed"/>
    <authored value="2013-06-18T00:00:00+01:00"/>
    <!--Fictive, only the below answers are non-fictive-->
    <subject>
        <reference value="Patient/f201"/>
        <display value="Roel"/>
    </subject>
    <author>
        <reference value="Practitioner/f201"/>
    </author>
    <source>
        <reference value="Practitioner/f201"/>
    </source>
    <name>
        <coding>
            <system value="https://lifelines.nl"/>
            <code value="VL 1-1, 18-65_1.2.2"/>
            <display value="Lifelines Questionnaire 1 part 1"/>
        </coding>
    </name>
    <identifier>
        <use value="temp"/>
        <label value="Roel's VL 1-1, 18-65_1.2.2"/>
    </identifier>

    <group>
        <group>
            <question>
                <!--Seperate answer-->
                <text value="Do you have allergies?"/>
                <answerString value="I am allergic to house dust"/>
            </question>
        </group>
        <group>
            <!--Answers to general questions-->
            <header value="General questions"/>
            <question>
                <text value="What is your gender?"/>
                <answerString value="Male"/>
            </question>
            <question>
                <name>
                    <text value="What is your date of birth?"/>
                </name>
                <answerDate value="1960-03-13"/>
            </question>
            <question>
                <name>
                    <text value="What is your country of birth?"/>
                </name>
                <answerString value="The Netherlands"/>
            </question>
            <question>
                <name>
                    <text value="What is your marital status?"/>
                </name>
                <answerString value="married"/>
            </question>
        </group>

        <group>
            <!--Answers to intoxications-->
            <header value="Intoxications"/>

            <question>
                <text value="Do you smoke?"/>
                <answerString value="No"/>
            </question>
            <question>
                <text value="Do you drink alchohol?"/>
                <answerString value="No, but I used to drink"/>
            </question>
        </group>
    </group>
</Questionnaire>
