  | 
                                       Patient Data | 
                                     
                                    
                                       | 
                                          
                                        | 
                                     
                                    
                                       | Concept | 
                                       
                                             
                                                    | 
                                                Identification | 
                                              
                                             
                                                | 
                                                   
                                                 | 
                                              
                                             
                                                | Concept | 
                                                
                                                      
                                                           | 
                                                         National Health Care patient ID (country of affiliation) | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                    
                                                      
                                                           | 
                                                         National Health Care patient ID (country of treatment) | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                    
                                                      
                                                           | 
                                                         Other Identifier | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                    
                                                 | 
                                              
                                           
                                             
                                                    | 
                                                Personal Information | 
                                              
                                             
                                                | 
                                                   
                                                 | 
                                              
                                             
                                                | Concept | 
                                                
                                                      
                                                             | 
                                                         Full Name | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                      
                                                         | Concept | 
                                                         
                                                               
                                                                    | 
                                                                  Given name | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Family Name/Surname | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Prefix | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Suffix | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                          | 
                                                       
                                                    
                                                      
                                                           | 
                                                         Date of Birth | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                    
                                                      
                                                           | 
                                                         Gender | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                    
                                                 | 
                                              
                                           
                                             
                                                    | 
                                                Contact Information | 
                                              
                                             
                                                | 
                                                   
                                                 | 
                                              
                                             
                                                | Concept | 
                                                
                                                      
                                                             | 
                                                         Address | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                      
                                                         | Concept | 
                                                         
                                                               
                                                                    | 
                                                                  Street | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Number of Street | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  City | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Postal Code | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  State or Province | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Country | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                          | 
                                                       
                                                    
                                                      
                                                             | 
                                                         Telecom | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                      
                                                         | Concept | 
                                                         
                                                               
                                                                    | 
                                                                  Telephone No | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Email | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                          | 
                                                       
                                                    
                                                      
                                                             | 
                                                         Preferred HP to contact | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                      
                                                         | Concept | 
                                                         
                                                               
                                                                      | 
                                                                  Full Name | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                               
                                                                  | Concept | 
                                                                  
                                                                        
                                                                             | 
                                                                           Given Name | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                             | 
                                                                           Family Name/Surname | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                             | 
                                                                           Prefix | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                             | 
                                                                           Suffix | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Telephone No | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Email | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                          | 
                                                       
                                                    
                                                 | 
                                              
                                           
                                        | 
                                     
                                  
                                    
                                           | 
                                       Clinical Data | 
                                     
                                    
                                       | 
                                          
                                        | 
                                     
                                    
                                       | Concept | 
                                       
                                             
                                                    | 
                                                Medication | 
                                              
                                             
                                                | 
                                                   
                                                 | 
                                              
                                             
                                                | Concept | 
                                                
                                                      
                                                             | 
                                                         Dispense | 
                                                       
                                                      
                                                         | 
                                                            
                                                          | 
                                                       
                                                      
                                                         | Concept | 
                                                         
                                                               
                                                                    | 
                                                                  Dispense identification | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Date of issue of dispense | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Related Prescription | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Substitution | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Duration of treatment | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Date of onset of treatment according to prescription | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Validity of prescription | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Date of onset of dispense | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                    | 
                                                                  Expected date of end of treatment | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                             
                                                               
                                                                      | 
                                                                  Dispenser | 
                                                                
                                                               
                                                                  | 
                                                                     
                                                                   | 
                                                                
                                                               
                                                                  | Concept | 
                                                                  
                                                                        
                                                                             | 
                                                                           Timestamp of dispensing | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                             | 
                                                                           Dispenser Identification | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                               | 
                                                                           Dispenser Full Name | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                        
                                                                           | Concept | 
                                                                           
                                                                                 
                                                                                      | 
                                                                                    Given | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Family Name/Surname | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Prefix | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Suffix | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                               | 
                                                                           Dispenser Telecom | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                        
                                                                           | Concept | 
                                                                           
                                                                                 
                                                                                      | 
                                                                                    Telephone No | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Email | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                               | 
                                                                           Dispenser Healthcare Facility | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                        
                                                                           | Concept | 
                                                                           
                                                                                 
                                                                                      | 
                                                                                    Identifier | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Name | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                        | 
                                                                                    Address | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                                 
                                                                                    | Concept | 
                                                                                    
                                                                                          
                                                                                               | 
                                                                                             Street | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             Number of Street | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             City | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             Postal Code | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             State or Province | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             Country | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                        | 
                                                                                    Healthcare Facility Telecom | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                                 
                                                                                    | Concept | 
                                                                                    
                                                                                          
                                                                                               | 
                                                                                             Telephone No | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                          
                                                                                               | 
                                                                                             Email | 
                                                                                           
                                                                                          
                                                                                             | 
                                                                                                
                                                                                              | 
                                                                                           
                                                                                        
                                                                                     | 
                                                                                  
                                                                               
                                                                            | 
                                                                         
                                                                      
                                                                        
                                                                               | 
                                                                           Dispenser Credentialing Organization | 
                                                                         
                                                                        
                                                                           | 
                                                                              
                                                                            | 
                                                                         
                                                                        
                                                                           | Concept | 
                                                                           
                                                                                 
                                                                                      | 
                                                                                    Identification | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                                 
                                                                                      | 
                                                                                    Name | 
                                                                                  
                                                                                 
                                                                                    | 
                                                                                       
                                                                                     | 
                                                                                  
                                                                               
                                                                            | 
                                                                         
                                                                      
                                                                   | 
                                                                
                                                             
                                                          | 
                                                       
                                                    
                                                 | 
                                              
                                           
                                        | 
                                     
                                  
                               | 
                            
                         
                      | 
                   
                
             |