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<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
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<realmCode code="IT"/>
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<typeId assigningAuthorityName="HL7 Italia" extension="POCD_MT000040UV02" root="2.16.840.1.113883.1.3"/>
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<templateId assigningAuthorityName="HL7 Italia" extension="1.1" root="2.16.840.1.113883.2.9.10.1.9.1"/>
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<id assigningAuthorityName="Regione Piemonte" displayable="true" extension="104.25RIS29-1" root="2.16.840.1.113883.2.9.2.70.4.4"/>
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<code code="11488-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Nota di consulto"/>
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<title>Referto di Specialistica Ambulatoriale</title>
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<effectiveTime value="20251119103100+0100"/>
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<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" codeSystemName="HL7 Confidentiality" displayName="Normal"/>
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<languageCode code="it-IT"/>
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<setId extension="104.25RIS29-1" root="2.16.840.1.113883.2.9.2.70.4.4"/>
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<versionNumber value="1"/>
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<recordTarget>
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<patientRole>
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<id assigningAuthorityName="Ministero Economia e Finanze" displayable="true" extension="AAABBB90A01A123A" root="2.16.840.1.113883.2.9.4.3.2"/>
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<id assigningAuthorityName="Regione Piemonte" displayable="true" extension="TX9057924" root="2.16.840.1.113883.2.9.2.10212.4.1"/>
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<patient>
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<name>
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<family>VENTIQUATTRO</family>
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<given>PASQUA</given>
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</name>
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<administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1" codeSystemName="HL7 AdministrativeGender" displayName="Femmina"/>
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<birthTime value="19970526000000"/>
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<birthplace>
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<place>
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<addr>
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<city>ABANO TERME</city>
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<country>IT</country>
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<censusTract>028001</censusTract>
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<postalCode/>
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</addr>
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</place>
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</birthplace>
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</patient>
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</patientRole>
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</recordTarget>
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<author typeCode="AUT">
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<time value="20251119103100"/>
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<assignedAuthor>
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<id assigningAuthorityName="Ministero Economia e Finanze" displayable="true" extension="PROXY_SIGN_ASLAT" root="2.16.840.1.113883.2.9.4.3.2"/>
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<telecom use="WP" value="mailto:@"/>
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<assignedPerson>
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<name>
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<given>Marco</given>
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<family>Todde</family>
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</name>
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</assignedPerson>
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</assignedAuthor>
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</author>
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<custodian>
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<assignedCustodian>
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<representedCustodianOrganization>
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<id assigningAuthorityName="Ministero della Salute" extension="070105" root="2.16.840.1.113883.2.9.4.1.1"/>
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<name>AZIENDA SANITARIA ASTI</name>
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</representedCustodianOrganization>
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</assignedCustodian>
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</custodian>
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<legalAuthenticator>
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<time value="20251119103100+0100"/>
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<signatureCode code="S"/>
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<assignedEntity>
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<id assigningAuthorityName="Ministero Economia e Finanze" displayable="true" extension="PROXY_SIGN_ASLAT" root="2.16.840.1.113883.2.9.4.3.2"/>
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<assignedPerson>
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<name>
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<family>Todde</family>
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<given>Marco</given>
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</name>
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</assignedPerson>
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</assignedEntity>
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</legalAuthenticator>
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<inFulfillmentOf>
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<order>
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<id assigningAuthorityName="Ministero delle Finanze" displayable="true" extension="030A12345678901" root="2.16.840.1.113883.2.9.4.3.9"/>
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<id assigningAuthorityName="PACS" displayable="true" extension="RIS75" root="1.2.840.10008.2.16.4"/>
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</order>
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</inFulfillmentOf>
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<documentationOf>
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<serviceEvent>
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<code code="PROG" codeSystem="2.16.840.1.113883.2.9.5.1.4" codeSystemName="ActCode" displayName="Accesso Programmato"/>
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<effectiveTime value="20251119103110+0100"/>
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</serviceEvent>
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</documentationOf>
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<componentOf>
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<encompassingEncounter>
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<effectiveTime>
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<low value="20251119103110+0100"/>
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<high value="20251119103110+0100"/>
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</effectiveTime>
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<id assigningAuthorityName="Regione Piemonte" displayable="true" extension="C990009941352" root=""/>
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<location>
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<healthCareFacility>
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<serviceProviderOrganization>
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<id assigningAuthorityName="Ministero della Salute" extension="010212" root="2.16.840.1.113883.2.9.4.1.2"/>
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<asOrganizationPartOf>
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<id extension="010212" root="2.16.840.1.113883.2.9.4.1.1"/>
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</asOrganizationPartOf>
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</serviceProviderOrganization>
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</healthCareFacility>
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</location>
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</encompassingEncounter>
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</componentOf>
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<component>
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<structuredBody>
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<component>
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<section ID="Quesito_Diagnostico">
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<code code="29299-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Motivo della visita"/>
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<title>Quesito diagnostico</title>
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<text>
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<paragraph>
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<caption>Quesito diagnostico</caption>
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<content ID="QRIS29-1"/>
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</paragraph>
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</text>
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</section>
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</component>
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<component>
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<section ID="PRESTAZIONI">
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<code code="62387-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Interventi"/>
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<title>Prestazioni</title>
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<text>
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<paragraph>
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<caption>Elenco procedure eseguite e data di esecuzione</caption>
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<content>ECG 19.11.2025 10:31:10\.br\</content>
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</paragraph>
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</text>
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<entry typeCode="DRIV">
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<act classCode="ACT" moodCode="EVN">
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<code code="CT_14951" codeSystem="2.16.840.1.113883.2.9.2.70.6.11" codeSystemName="Dizionario prestazioni sanitarie Regione Liguria" displayName="ECG"/>
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<text>
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<reference value="E-CT_14951-RIS29-1"/>
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</text>
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<effectiveTime value="20251119103110+0100"/>
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</act>
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</entry>
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</section>
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</component>
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<component>
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<section ID="REFERTO">
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<code code="47045-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Referto"/>
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<title>Referto</title>
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<text>
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<paragraph>
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<caption>Testo del Referto</caption>
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<content ID="RRIS29-1">TEST CDA</content>
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</paragraph>
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</text>
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</section>
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</component>
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</structuredBody>
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</component>
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</ClinicalDocument>
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