{
  "description": "Questionnaire for DVC Logical Model with the WHO PreQual DB",
  "_filename": "Questionnaire-PreQual.json",
  "package_name": "smart.who.int.trust-phw",
  "date": "2025-10-07T06:40:24+00:00",
  "meta": {
    "profile": [ "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap" ]
  },
  "publisher": "WHO",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "name": null,
  "item": [ {
    "text": "Full Name of the client",
    "type": "string",
    "linkId": "name",
    "repeats": true,
    "required": false
  }, {
    "text": "Date of Birth",
    "type": "date",
    "linkId": "dob",
    "repeats": true,
    "required": false
  }, {
    "text": "Sex",
    "type": "choice",
    "linkId": "sex",
    "repeats": false,
    "required": false,
    "answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0001"
  }, {
    "text": "Nationality",
    "type": "choice",
    "linkId": "nationality",
    "repeats": false,
    "required": false,
    "answerValueSet": "http://terminology.hl7.org/ValueSet/v3-Country"
  }, {
    "text": "National Identification Document",
    "type": "string",
    "linkId": "nid",
    "repeats": false,
    "required": false
  }, {
    "text": "National ID Document Type",
    "type": "choice",
    "linkId": "ndt",
    "repeats": false,
    "required": false,
    "answerValueSet": "http://terminology.hl7.org/ValueSet/v2-0203"
  }, {
    "item": [ {
      "text": "Name of Parent or Guardian",
      "type": "string",
      "linkId": "guardianName",
      "repeats": false,
      "required": false
    } ],
    "text": "Parent or Guardian Details",
    "type": "group",
    "linkId": "guardian",
    "repeats": false,
    "required": false
  }, {
    "item": [ {
      "text": "Vaccine or Prophylaxis ID",
      "type": "choice",
      "linkId": "productID",
      "repeats": true,
      "required": false,
      "answerValueSet": "http://smart.who.int/pcmt-vaxprequal/ValueSet/PreQualProductIds"
    }, {
      "text": "Date of Vaccination",
      "type": "date",
      "linkId": "date",
      "repeats": true,
      "required": false
    }, {
      "text": "Name of supervising clinician",
      "type": "string",
      "linkId": "clinicianName",
      "repeats": false,
      "required": false
    }, {
      "text": "Relevant authoring responsible for issuing the certificate, or for overseeing the administration center",
      "type": "string",
      "linkId": "issuer",
      "repeats": false,
      "required": false
    }, {
      "text": "Batch Number",
      "type": "string",
      "linkId": "batchNo.text",
      "repeats": true,
      "required": false
    }, {
      "item": [ {
        "text": "From",
        "type": "date",
        "linkId": "startDate",
        "repeats": false,
        "required": false
      }, {
        "text": "To",
        "type": "date",
        "linkId": "endDate",
        "repeats": false,
        "required": false
      } ],
      "text": "Certificate Validity Period",
      "type": "group",
      "linkId": "validityPeriod",
      "repeats": false,
      "required": false
    } ],
    "text": "Vaccine Certificate Details",
    "type": "group",
    "linkId": "vaccineDetails",
    "repeats": true,
    "required": true
  }, {
    "text": "Upload Paper Form image or PDF",
    "type": "attachment",
    "linkId": "attachment",
    "repeats": false,
    "required": false
  } ],
  "type": null,
  "experimental": null,
  "resourceType": "Questionnaire",
  "title": "DVC Model Questionnaire",
  "package_version": "0.1.0",
  "status": "active",
  "id": "b9da28e5-dee6-49c9-85f4-429b57e3d56c",
  "kind": null,
  "url": "http://smart.who.int/trust-phw/Questionnaire/PreQual",
  "version": "0.1.0",
  "contact": [ {
    "name": "WHO",
    "telecom": [ {
      "value": "http://who.int",
      "system": "url"
    } ]
  } ]
}