Integrated Campaign Registry (ICR) Implementation Guide
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: Referral — zero-dose child to routine immunization, Rokupr CHC - XML Representation

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<ServiceRequest xmlns="http://hl7.org/fhir">
  <id value="example-referral"/>
  <meta>
    <profile
             value="https://icr.healthcampaigns.org/StructureDefinition/ICRReferral"/>
    <tag>
      <system
              value="https://icr.healthcampaigns.org/CodeSystem/icr-project-tag-cs"/>
      <code value="mr-sia"/>
      <display value="MR SIA (Sierra Leone)"/>
    </tag>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ServiceRequest example-referral</b></p><a name="example-referral"> </a><a name="hcexample-referral"> </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-ICRReferral.html">ICR Referral</a></p><p style="margin-bottom: 0px">Tag: <a href="CodeSystem-icr-project-tag-cs.html">MR SIA (Sierra Leone) (Details: ICR Project Tag code mr-sia = 'MR SIA (Sierra Leone)')</a></p></div><p><b>Referring Task</b>: <a href="Task-example-mopup-task.html">Task </a></p><p><b>basedOn</b>: <a href="CarePlan-example-mr-sia-2026.html">CarePlan Measles–rubella SIA, Kambia District, June 2026 (round 1)</a></p><p><b>status</b>: Completed</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title="Codes:{https://icr.healthcampaigns.org/CodeSystem/icr-referral-category-cs campaign-referral}">Campaign referral</span></p><p><b>priority</b>: Routine</p><p><b>subject</b>: <a href="Patient-example-child.html">Aminata Kamara  Female, DoB: 2023-04-12 ( https://icr.healthcampaigns.org/identifiers/national-id#SL-2023-04-0099812)</a></p><p><b>occurrence</b>: 2026-07-01</p><p><b>authoredOn</b>: 2026-06-24 09:45:00+0000</p><p><b>requester</b>: Fatmata Sesay (vaccinator, mop-up team 4)</p><p><b>performer</b>: <a href="Organization-example-facility-org.html">Organization Rokupr Community Health Centre</a></p><p><b>locationReference</b>: <a href="Location-example-facility.html">Location Rokupr Community Health Centre</a></p><p><b>reasonCode</b>: <span title="Codes:{https://icr.healthcampaigns.org/CodeSystem/icr-referral-reason-cs zero-dose-to-routine}">Zero-dose child, to routine immunization</span></p><p><b>supportingInfo</b>: <a href="Immunization-example-mcv-dose.html">Immunization: extension = campaign,-&gt;CarePlan Measles–rubella SIA, Kambia District, June 2026 (round 1),zero-dose; status = completed; vaccineCode = measles virus vaccine; occurrence[x] = 2026-06-24 09:40:00+0000; lotNumber = MRV-2026-0412</a></p><p><b>note</b>: </p><blockquote><div><p>Child had never been vaccinated; MCV given at the mop-up visit. Caregiver asked to bring the child for the routine schedule.</p>
</div></blockquote></div>
  </text>
  <extension
             url="https://icr.healthcampaigns.org/StructureDefinition/referring-task">
    <valueReference>🔗 
      <reference value="Task/example-mopup-task"/>
    </valueReference>
  </extension>
  <basedOn>🔗 
    <reference value="CarePlan/example-mr-sia-2026"/>
  </basedOn>
  <status value="completed"/>
  <intent value="order"/>
  <category>
    <coding>
      <system
              value="https://icr.healthcampaigns.org/CodeSystem/icr-referral-category-cs"/>
      <code value="campaign-referral"/>
      <display value="Campaign referral"/>
    </coding>
  </category>
  <priority value="routine"/>
  <subject>🔗 
    <reference value="Patient/example-child"/>
  </subject>
  <occurrenceDateTime value="2026-07-01"/>
  <authoredOn value="2026-06-24T09:45:00Z"/>
  <requester>
    <display value="Fatmata Sesay (vaccinator, mop-up team 4)"/>
  </requester>
  <performer>🔗 
    <reference value="Organization/example-facility-org"/>
  </performer>
  <locationReference>🔗 
    <reference value="Location/example-facility"/>
  </locationReference>
  <reasonCode>
    <coding>
      <system
              value="https://icr.healthcampaigns.org/CodeSystem/icr-referral-reason-cs"/>
      <code value="zero-dose-to-routine"/>
      <display value="Zero-dose child, to routine immunization"/>
    </coding>
  </reasonCode>
  <supportingInfo>🔗 
    <reference value="Immunization/example-mcv-dose"/>
  </supportingInfo>
  <note>
    <text
          value="Child had never been vaccinated; MCV given at the mop-up visit. Caregiver asked to bring the child for the routine schedule."/>
  </note>
</ServiceRequest>