| Level/ Type | 
                              Code | 
                              Display Name | 
                              Code System | 
                           
                           
                              | 0‑L | 
                              
                                  1 
                               | 
                              
                                  Active Ingredient 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  10 
                               | 
                              
                                  Clinical Manifestation 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  107 
                               | 
                              
                                  I confirm that the patient –data subject has consented to the following statement:
                                    ‘I agree that my Patient Summary may be transferred to a registered Health Professional
                                    in [COUNTRY B] for the purposes of providing me with medical care and/or medication’
                                  
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  11 
                               | 
                              
                                  Closed/Inactive Problem 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  12 
                               | 
                              
                                  Contact Information 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  13 
                               | 
                              
                                  Country 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  14 
                               | 
                              
                                  Country A Medicinal Product Code 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  15 
                               | 
                              
                                  Creation Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  16 
                               | 
                              
                                  Custodian 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  17 
                               | 
                              
                                  Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  18 
                               | 
                              
                                  Date To 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  19 
                               | 
                              
                                  Date of Birth 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  2 
                               | 
                              
                                  Active Problem 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  20 
                               | 
                              
                                  Date of Prescription 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  21 
                               | 
                              
                                  Device/Implant 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  22 
                               | 
                              
                                  Dispense 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  23 
                               | 
                              
                                  Dispensed Package Size 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  24 
                               | 
                              
                                  Dispensed Product 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  25 
                               | 
                              
                                  Dose Form 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  26 
                               | 
                              
                                  End Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  27 
                               | 
                              
                                  Every 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  28 
                               | 
                              
                                  Facility ID 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  29 
                               | 
                              
                                  Facility Name 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  3 
                               | 
                              
                                  Address 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  30 
                               | 
                              
                                  Family Name 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  31 
                               | 
                              
                                  for 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  32 
                               | 
                              
                                  Frequency of Intakes 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  33 
                               | 
                              
                                  Gender 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  34 
                               | 
                              
                                  Given Name 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  35 
                               | 
                              
                                  Guardian 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  36 
                               | 
                              
                                  Implant Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  37 
                               | 
                              
                                  Instructions to patient 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  38 
                               | 
                              
                                  Is substitution of brand name allowed? 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  39 
                               | 
                              
                                  Last Update 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  4 
                               | 
                              
                                  Advise to the dispenser 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  40 
                               | 
                              
                                  Legal Authenticator 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  41 
                               | 
                              
                                  National Insurance Number 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  42 
                               | 
                              
                                  No 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  43 
                               | 
                              
                                  Number of packages 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  44 
                               | 
                              
                                  Observation Type 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  45 
                               | 
                              
                                  Onset Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  46 
                               | 
                              
                                  Organisation Identifier 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  47 
                               | 
                              
                                  Organisation Name 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  48 
                               | 
                              
                                  Other Active Ingredients 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  49 
                               | 
                              
                                  Other Contacts 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  5 
                               | 
                              
                                  Agent 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  50 
                               | 
                              
                                  Package Size 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  51 
                               | 
                              
                                  Patient 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  52 
                               | 
                              
                                  Patient IDs 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  53 
                               | 
                              
                                  per unit 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  54 
                               | 
                              
                                  Preferred HP/Legal organization to contact 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  55 
                               | 
                              
                                  Prefix 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  56 
                               | 
                              
                                  Prescriber 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  57 
                               | 
                              
                                  Prescriber details 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  58 
                               | 
                              
                                  Prescription ID 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  59 
                               | 
                              
                                  Prescription Item Details 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  6 
                               | 
                              
                                  at 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  60 
                               | 
                              
                                  Prescription Item ID 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  61 
                               | 
                              
                                  Prescription Items List 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  62 
                               | 
                              
                                  Procedure 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  63 
                               | 
                              
                                  Procedure Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  64 
                               | 
                              
                                  Profession 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  65 
                               | 
                              
                                  Reaction Type 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  66 
                               | 
                              
                                  Regional/National Health ID 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  67 
                               | 
                              
                                  Route of Administration 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  68 
                               | 
                              
                                  See details 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  69 
                               | 
                              
                                  Specialty 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  7 
                               | 
                              
                                  Author (HP) 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  70 
                               | 
                              
                                  Strength 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  71 
                               | 
                              
                                  Substitute 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  72 
                               | 
                              
                                  The Active Problem section is missing ! 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  73 
                               | 
                              
                                  The Allergies, adverse reactions, alerts section is missing ! 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  74 
                               | 
                              
                                  The Medical Devices and implants section is missing ! 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  75 
                               | 
                              
                                  The Medication Summary section is missing ! 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  76 
                               | 
                              
                                  The History of Procedures section is missing ! 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  77 
                               | 
                              
                                  unit(s) 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  78 
                               | 
                              
                                  Units per intake 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  79 
                               | 
                              
                                  Vaccination 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  8 
                               | 
                              
                                  Authoring Device 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  80 
                               | 
                              
                                  Vaccination Date 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  81 
                               | 
                              
                                  Yes 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  82 
                               | 
                              
                                  I have identified the patient-data subject 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  83 
                               | 
                              
                                  I confirm that the patient –data subject has consented to the following statement:
                                    ‘I agree that my ePrescription may be transferred to a registered Health Professional
                                    in [COUNTRY B] for the purposes of providing me with medical care and/or medication’
                                  
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  84 
                               | 
                              
                                  Observation Value 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  85 
                               | 
                              
                                  Date From 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  9 
                               | 
                              
                                  Brand Name 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              | 0‑L | 
                              
                                  99 
                               | 
                              
                                  Physical Findings 
                               | 
                              epSOSDisplayLabel | 
                           
                           
                              
                                  
                               |