CCD Sample 3

<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"> <realmCode code="US"/> <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/> <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="183427c2-2021-724a-1a9e-001A64958C30"/> <code code="34133-9" codeSystem="2.16.840.1.113883.6.1" displayName="Summarization of Episode Note"/> <title>Ambulatory Summary</title> <effectiveTime value="20210406071234-0400"/> <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/> <languageCode code="en-US"/> <recordTarget> <patientRole> <id extension="INT42441" root="2.16.840.1.113883.3.564.28492"/> <addr use="HP"> <streetAddressLine>INT42441 RATE</streetAddressLine> <streetAddressLine nullFlavor="NI"/> <city>NAKAMOTO</city> <state>MD</state> <postalCode>21075</postalCode> <country>US</country> </addr> <patient> <name> <given>SIXPM</given> <family>INT42441</family> </name>