The following content has been modified for better visualization. Validation will be performed on original content
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<soapenv:Envelope xmlns:soapenv="http://www.w3.org/2003/05/soap-envelope">
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<soapenv:Header xmlns:wsa="http://www.w3.org/2005/08/addressing">
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<wsa:Action xmlns:mustUnderstand="http://www.w3.org/2003/05/soap-envelope" mustUnderstand:mustUnderstand="true">urn:hl7-org:v3:PRPA_IN201302UV02</wsa:Action>
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<wsa:ReplyTo xmlns:mustUnderstand="http://www.w3.org/2003/05/soap-envelope" mustUnderstand:mustUnderstand="true">
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<wsa:Address>http://www.w3.org/2005/08/addressing/anonymous</wsa:Address>
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</wsa:ReplyTo>
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</soapenv:Header>
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<soapenv:Body>
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<ns1:PRPA_IN201302UV02 xmlns:ns1="urn:hl7-org:v3" ITSVersion="XML_1.0">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" extension="ea737196-1658-410a-8443-15090b65e8a4" root="2.16.840.1.113883.1.6.1" xsi:type="ns1:II"/>
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<ns1:creationTime xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" value="20251202130904" xsi:type="ns1:TS"/>
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<ns1:interactionId xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" extension="PRPA_IN201302UV02" root="2.16.840.1.113883.1.6" xsi:type="ns1:II"/>
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<ns1:processingCode code="P"/>
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<ns1:processingModeCode code="T"/>
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<ns1:acceptAckCode code="AL"/>
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<ns1:receiver typeCode="RCV">
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<ns1:device classCode="DEV" determinerCode="INSTANCE">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.6.5.100.70" xsi:type="ns1:II"/>
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<ns1:asAgent classCode="AGNT">
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<ns1:representedOrganization classCode="ORG" determinerCode="INSTANCE">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.6.5.100.70" xsi:type="ns1:II"/>
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</ns1:representedOrganization>
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</ns1:asAgent>
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</ns1:device>
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</ns1:receiver>
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<ns1:sender typeCode="SND">
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<ns1:device classCode="DEV" determinerCode="INSTANCE">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:II"/>
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<ns1:asAgent classCode="AGNT">
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<ns1:representedOrganization classCode="ORG" determinerCode="INSTANCE">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:II"/>
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</ns1:representedOrganization>
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</ns1:asAgent>
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</ns1:device>
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</ns1:sender>
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<ns1:controlActProcess classCode="CACT" moodCode="EVN">
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<ns1:code xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" code="PRPA_TE201302UV02" xsi:type="ns1:CD"/>
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<ns1:subject contextConductionInd="false" typeCode="SUBJ">
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<ns1:registrationEvent classCode="REG" moodCode="EVN">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" nullFlavor="NA" xsi:type="ns1:II"/>
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<ns1:statusCode code="active"/>
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<ns1:subject1 typeCode="SBJ">
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<ns1:patient classCode="PAT">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" extension="PIX" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:PRPA_MT201302UV02.Patient.id"/>
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" extension="0d077439-5897-4435-bcce-e068119d6e7e" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:PRPA_MT201302UV02.Patient.id"/>
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<ns1:statusCode xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" code="active" xsi:type="ns1:PRPA_MT201302UV02.Patient.statusCode"/>
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<ns1:veryImportantPersonCode code="VIP"/>
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<ns1:patientPerson xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" classCode="PSN" determinerCode="INSTANCE" xsi:type="ns1:PRPA_MT201302UV02.Patient.patientPerson">
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<ns1:name xsi:type="ns1:PN">
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<ns1:given>ALAN</ns1:given>
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<ns1:family>ALPHA</ns1:family>
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</ns1:name>
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<ns1:telecom value="+1135798341" xsi:type="ns1:TEL"/>
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<ns1:administrativeGenderCode nullFlavor="UNK"/>
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<ns1:birthTime value="19380224" xsi:type="ns1:TS"/>
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<ns1:deceasedInd value="true" xsi:type="ns1:BL"/>
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<ns1:deceasedTime value="19990224" xsi:type="ns1:TS"/>
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<ns1:addr xsi:type="ns1:AD">
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<ns1:country>USA</ns1:country>
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<ns1:city>WEBSTER</ns1:city>
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<ns1:state>MO</ns1:state>
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<ns1:postalCode>63119</ns1:postalCode>
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<ns1:streetName>1 PINETREE</ns1:streetName>
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</ns1:addr>
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<ns1:asCitizen classCode="CIT">
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<ns1:politicalNation classCode="NAT" determinerCode="INSTANCE">
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<ns1:code code="at"/>
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</ns1:politicalNation>
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</ns1:asCitizen>
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<ns1:asOtherIDs classCode="PAT">
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<ns1:id extension="PIXRR" root="2.16.840.1.113883.3.72.6.5.100.70" xsi:type="ns1:PRPA_MT201302UV02.OtherIDs.id"/>
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<ns1:statusCode code="active"/>
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<ns1:scopingOrganization classCode="ORG" determinerCode="INSTANCE">
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<ns1:id root="2.16.840.1.113883.3.72.6.5.100.70" xsi:type="ns1:II"/>
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</ns1:scopingOrganization>
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</ns1:asOtherIDs>
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<ns1:birthPlace>
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<ns1:addr xsi:type="ns1:AD">
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<ns1:country>USA</ns1:country>
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<ns1:city>WEBSTER</ns1:city>
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<ns1:state>MO</ns1:state>
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<ns1:postalCode>63119</ns1:postalCode>
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<ns1:streetName>1 PINETREE</ns1:streetName>
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</ns1:addr>
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</ns1:birthPlace>
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<ns1:languageCommunication>
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<ns1:languageCode code="en"/>
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</ns1:languageCommunication>
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</ns1:patientPerson>
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<ns1:providerOrganization classCode="ORG" determinerCode="INSTANCE">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:II"/>
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<ns1:contactParty classCode="CON">
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<ns1:telecom xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" use="PUB" value="http://www.ith-icoserve.com" xsi:type="ns1:TEL"/>
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</ns1:contactParty>
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</ns1:providerOrganization>
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</ns1:patient>
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</ns1:subject1>
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<ns1:custodian typeCode="CST">
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<ns1:assignedEntity classCode="ASSIGNED">
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<ns1:id xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" root="2.16.840.1.113883.3.72.5.9.1" xsi:type="ns1:II"/>
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<ns1:assignedOrganization classCode="ORG" determinerCode="INSTANCE">
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<ns1:name xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:type="ns1:EN">
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<ns1:delimiter>2.16.840.1.113883.3.72.5.9.1</ns1:delimiter>
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</ns1:name>
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</ns1:assignedOrganization>
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</ns1:assignedEntity>
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</ns1:custodian>
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</ns1:registrationEvent>
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</ns1:subject>
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</ns1:controlActProcess>
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</ns1:PRPA_IN201302UV02>
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</soapenv:Body>
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</soapenv:Envelope>
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