Examplev0.1.0·activeESPEN
EspenMDADrugReceipt
ESPEN MDA demo Form 2 (medicine receipt at health facility): disease and medicine-package scope, per-medicine received totals. Template-based extraction: one ICRSupplyDelivery per answered medicine total (espen-forms).
Form
Rendering interactive form…
| Item | Type | Flags | Link ID |
|---|---|---|---|
| Select the recorder ID | text | p_recorder_id | |
| Select State / Region / Province | text | req | p_state |
| Select District / LGA / County | text | req | p_district |
| Enter the Health facility / Sub district | text | req | p_health_facility |
| Disease covered by the MDA | choice | req↻ | p_disease · icr-ntd-disease-vs |
| Select the medicine package | choice | req↻ | p_medicine · icr-mda-medicine-package-vs |
| Total Praziquantel received | integer | req? | p_total_pzq |
| Total Albendazole received | integer | req? | p_total_alb |
| Total Mebendazole received | integer | req? | p_total_meb |
| Total Ivermectin received | integer | req? | p_total_ivm |
| Total Diethylcarbamazine received | integer | req? | p_total_dec |
| Total Azithromycin suspension (in l) received | integer | req? | p_total_az_sus |
| Total Azithromycin tablets received | integer | req? | p_total_az_tab |
| Total Tetracycline received | integer | req? | p_total_tetra |
| Additional Note | long text | p_add_note |
{
"resourceType": "Questionnaire",
"id": "espen-mda-drug-receipt",
"meta": {
"tag": [
{
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-project-tag-cs",
"code": "espen",
"display": "ESPEN"
}
]
},
"text": {
"status": "extensions",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire espen-mda-drug-receipt</b></p><a name=\"espen-mda-drug-receipt\"> </a><a name=\"hcespen-mda-drug-receipt\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Tag: <a href=\"CodeSystem-icr-project-tag-cs.html\">ESPEN (Details: ICR Project Tag code espen = 'ESPEN')</a></p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> EspenMDADrugReceipt</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">ESPEN MDA demo Form 2 (medicine receipt at health facility): disease and medicine-package scope, per-medicine received totals. Template-based extraction: one ICRSupplyDelivery per answered medicine total (espen-forms).</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">https://icr.healthcampaigns.org/Questionnaire/espen-mda-drug-receipt#0.1.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_recorder_id\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> p_recorder_id</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Select the recorder ID</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_state\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> p_state</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Select State / Region / Province</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_district\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> p_district</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Select District / LGA / County</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_health_facility\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> p_health_facility</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enter the Health facility / Sub district</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_disease\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p_disease</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Disease covered by the MDA</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-icr-ntd-disease-vs.html\">ICR NTD Disease</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_medicine\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> p_medicine</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Select the medicine package</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Value Set: <a href=\"ValueSet-icr-mda-medicine-package-vs.html\">ICR MDA Medicine Package</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_pzq\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_pzq</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Praziquantel received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <ul><li><a href=\"#item.p_medicine\">p_medicine</a> = PZQ (praziquantel) (ICR MDA Medicine Package#pzq)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = PZQ + ALB (ICR MDA Medicine Package#pzq-alb)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = PZQ + MEB (ICR MDA Medicine Package#pzq-meb)</li></ul></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_alb\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_alb</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Albendazole received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <ul><li><a href=\"#item.p_medicine\">p_medicine</a> = ALB (albendazole) (ICR MDA Medicine Package#alb)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = IVM + ALB (ICR MDA Medicine Package#ivm-alb)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = PZQ + ALB (ICR MDA Medicine Package#pzq-alb)</li></ul></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_meb\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_meb</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Mebendazole received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <ul><li><a href=\"#item.p_medicine\">p_medicine</a> = MEB (mebendazole) (ICR MDA Medicine Package#meb)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = PZQ + MEB (ICR MDA Medicine Package#pzq-meb)</li></ul></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_ivm\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_ivm</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Ivermectin received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <ul><li><a href=\"#item.p_medicine\">p_medicine</a> = IVM (ivermectin) (ICR MDA Medicine Package#ivm)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = IVM + ALB (ICR MDA Medicine Package#ivm-alb)</li><li><a href=\"#item.p_medicine\">p_medicine</a> = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)</li></ul></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_dec\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_dec</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Diethylcarbamazine received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p_medicine\">p_medicine</a> = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_az_sus\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_az_sus</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Azithromycin suspension (in l) received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p_medicine\">p_medicine</a> = AZM suspension (azithromycin) (ICR MDA Medicine Package#azm-susp)</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_az_tab\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_az_tab</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Azithromycin tablets received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p_medicine\">p_medicine</a> = AZM tablets (azithromycin) (ICR MDA Medicine Package#azm-tab)</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.p_total_tetra\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-integer.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"integer\" class=\"hierarchy\"/> p_total_tetra</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Total Tetracycline received</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-integer\">integer</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.p_medicine\">p_medicine</a> = TETRA (tetracycline eye ointment) (ICR MDA Medicine Package#tetra)</span></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.p_add_note\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> p_add_note</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Additional Note</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><h2>Contained Resources</h2><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-pzq</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-pzq\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-pzq\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc P02BA01}\">praziquantel</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-alb</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-alb\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-alb\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc P02CA03}\">albendazole</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-meb</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-meb\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-meb\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc P02CA01}\">mebendazole</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-ivm</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-ivm\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-ivm\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc P02CF01}\">ivermectin</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-dec</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-dec\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-dec\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc P02CB02}\">diethylcarbamazine</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-azm-susp</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-azm-susp\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-azm-susp\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> liters<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codeL = 'L')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc J01FA10}\">azithromycin (suspension)</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-azm-tab</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-azm-tab\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-azm-tab\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tablets<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tbl} = '{tbl}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc J01FA10}\">azithromycin (tablets)</span></td></tr></table><hr/><p class=\"res-header-id\"><b>SupplyDelivery #sd-receipt-tetra</b></p><a name=\"espen-mda-drug-receipt/sd-receipt-tetra\"> </a><a name=\"hcespen-mda-drug-receipt/sd-receipt-tetra\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ICRSupplyDelivery.html\">ICR Supply Delivery</a></p></div><p><b>Record Origin</b>: campaign</p><p><b>status</b>: Delivered</p><h3>SuppliedItems</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Item[x]</b></td></tr><tr><td style=\"display: none\">*</td><td> tubes<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{tube} = '{tube}')</span></td><td><span title=\"Codes:{http://www.whocc.no/atc S01AA09}\">tetracycline (eye ointment)</span></td></tr></table></div>"
},
"contained": [
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-pzq",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_pzq').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "P02BA01",
"display": "praziquantel"
}
]
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-alb",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_alb').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "P02CA03",
"display": "albendazole"
}
]
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-meb",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_meb').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "P02CA01",
"display": "mebendazole"
}
]
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-ivm",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_ivm').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "P02CF01",
"display": "ivermectin"
}
]
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-dec",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_dec').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "P02CB02",
"display": "diethylcarbamazine"
}
]
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-azm-susp",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_az_sus').answer.value.first()"
}
]
},
"unit": "liters",
"system": "http://unitsofmeasure.org",
"code": "L"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "J01FA10",
"display": "azithromycin"
}
],
"text": "azithromycin (suspension)"
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-azm-tab",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_az_tab').answer.value.first()"
}
]
},
"unit": "tablets",
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "J01FA10",
"display": "azithromycin"
}
],
"text": "azithromycin (tablets)"
}
}
},
{
"resourceType": "SupplyDelivery",
"id": "sd-receipt-tetra",
"meta": {
"profile": [
"https://icr.healthcampaigns.org/StructureDefinition/ICRSupplyDelivery"
]
},
"extension": [
{
"url": "https://icr.healthcampaigns.org/StructureDefinition/record-origin",
"valueCode": "campaign"
}
],
"status": "completed",
"suppliedItem": {
"quantity": {
"_value": {
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtractValue",
"valueString": "%resource.repeat(item).where(linkId='p_total_tetra').answer.value.first()"
}
]
},
"unit": "tubes",
"system": "http://unitsofmeasure.org",
"code": "{tube}"
},
"itemCodeableConcept": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "S01AA09",
"display": "tetracycline"
}
],
"text": "tetracycline (eye ointment)"
}
}
}
],
"url": "https://icr.healthcampaigns.org/Questionnaire/espen-mda-drug-receipt",
"version": "0.1.0",
"name": "EspenMDADrugReceipt",
"status": "active",
"experimental": false,
"subjectType": [
"Location"
],
"date": "2026-07-05T20:56:14+00:00",
"publisher": "UNICEF",
"contact": [
{
"name": "UNICEF",
"telecom": [
{
"system": "url",
"value": "https://www.unicef.org"
}
]
}
],
"description": "ESPEN MDA demo Form 2 (medicine receipt at health facility): disease and medicine-package scope, per-medicine received totals. Template-based extraction: one ICRSupplyDelivery per answered medicine total (espen-forms).",
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001",
"display": "World"
}
]
}
],
"item": [
{
"linkId": "p_recorder_id",
"text": "Select the recorder ID",
"type": "string"
},
{
"linkId": "p_state",
"text": "Select State / Region / Province",
"type": "string",
"required": true
},
{
"linkId": "p_district",
"text": "Select District / LGA / County",
"type": "string",
"required": true
},
{
"linkId": "p_health_facility",
"text": "Enter the Health facility / Sub district",
"type": "string",
"required": true
},
{
"linkId": "p_disease",
"text": "Disease covered by the MDA",
"type": "choice",
"required": true,
"repeats": true,
"answerValueSet": "https://icr.healthcampaigns.org/ValueSet/icr-ntd-disease-vs"
},
{
"linkId": "p_medicine",
"text": "Select the medicine package",
"type": "choice",
"required": true,
"repeats": true,
"answerValueSet": "https://icr.healthcampaigns.org/ValueSet/icr-mda-medicine-package-vs"
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-pzq"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_pzq",
"text": "Total Praziquantel received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "pzq"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "pzq-alb"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "pzq-meb"
}
}
],
"enableBehavior": "any",
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-alb"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_alb",
"text": "Total Albendazole received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "alb"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm-alb"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm-alb-dec"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "pzq-alb"
}
}
],
"enableBehavior": "any",
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-meb"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_meb",
"text": "Total Mebendazole received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "meb"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "pzq-meb"
}
}
],
"enableBehavior": "any",
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-ivm"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_ivm",
"text": "Total Ivermectin received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm-alb"
}
},
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm-alb-dec"
}
}
],
"enableBehavior": "any",
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-dec"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_dec",
"text": "Total Diethylcarbamazine received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "ivm-alb-dec"
}
}
],
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-azm-susp"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_az_sus",
"text": "Total Azithromycin suspension (in l) received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "azm-susp"
}
}
],
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-azm-tab"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_az_tab",
"text": "Total Azithromycin tablets received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "azm-tab"
}
}
],
"required": true
},
{
"extension": [
{
"extension": [
{
"url": "template",
"valueReference": {
"reference": "#sd-receipt-tetra"
}
}
],
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-templateExtract"
}
],
"linkId": "p_total_tetra",
"text": "Total Tetracycline received",
"type": "integer",
"enableWhen": [
{
"question": "p_medicine",
"operator": "=",
"answerCoding": {
"system": "https://icr.healthcampaigns.org/CodeSystem/icr-mda-medicine-package-cs",
"code": "tetra"
}
}
],
"required": true
},
{
"linkId": "p_add_note",
"text": "Additional Note",
"type": "text"
}
]
}