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<PRPA_IN201301UV02 xmlns="urn:hl7-org:v3" ITSVersion="XML_1.0">
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<id extension="messageId" root="1.3.6.1.4.1.53515.1.3.3"/>
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<creationTime value="20251205093933"/>
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<versionCode code="Ballot2011May"/>
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<interactionId extension="PRPA_IN201301UV02" root="2.16.840.1.113883"/>
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<processingCode code="P"/>
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<processingModeCode code="T"/>
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<acceptAckCode code="AL"/>
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<receiver typeCode="RCV">
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<device classCode="DEV" determinerCode="INSTANCE">
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<id root="1.3.6.1.4.1.36302.2"/>
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</device>
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</receiver>
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<sender typeCode="SND">
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<device classCode="DEV" determinerCode="INSTANCE">
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<id root="1.3.6.1.4.1.53515.1.3.1"/>
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</device>
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</sender>
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<controlActProcess classCode="CACT" moodCode="EVN">
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<code code="PRPA_TE201301UV02"/>
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<subject contextConductionInd="false" typeCode="SUBJ">
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<registrationEvent classCode="REG" moodCode="EVN">
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<statusCode code="active"/>
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<subject1 typeCode="SBJ">
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<patient classCode="PAT">
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<id assigningAuthorityName="InsuranceNumber" extension="511112006" root="1.3.6.1.4.1.36302.100.111.7"/>
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<id assigningAuthorityName="ExternalId" extension="777779" root="1.3.6.1.4.1.36302.2.588110204"/>
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<id extension="707054" root="1.3.6.1.4.1.36302.100.6.1.1"/>
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<id extension="27001200" root="1.3.6.1.4.1.53515.1.3.7"/>
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<statusCode code="active"/>
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<patientPerson classCode="PSN" determinerCode="INSTANCE">
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<id extension="511112006" root="1.3.6.1.4.1.53515.1.3.4"/>
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<name>
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<en.given>Miroslav</en.given>
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<en.family>Krobot</en.family>
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</name>
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<telecom use="HP" value="tel:+420607888990"/>
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<administrativeGenderCode code="M"/>
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<birthTime value="19511112"/>
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<maritalStatusCode code="M"/>
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</patientPerson>
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<providerOrganization classCode="ORG" determinerCode="INSTANCE">
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<contactParty classCode="CON">
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<telecom use="WP" value="TODO contact phone or address or person"/>
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</contactParty>
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</providerOrganization>
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</patient>
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</subject1>
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<custodian typeCode="CST">
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<assignedEntity classCode="ASSIGNED"/>
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</custodian>
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</registrationEvent>
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</subject>
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</controlActProcess>
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</PRPA_IN201301UV02>
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