<?xml version="1.0" encoding="UTF-8"?>

<Provenance xmlns="http://hl7.org/fhir">
  <id value="prov-004"/>
  <meta>
    <profile value="http://fhir.tiro.health/StructureDefinition/form-provenance"/>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Provenance prov-004</b></p><a name="prov-004"> </a><a name="hcprov-004"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-form-provenance.html">Form Provenance</a></p></div><p>Provenance for <a href="QuestionnaireResponse-qr-123.html">Response to Questionnaire 'http://fhir.tiro.health/Questionnaire/example' about 'Unspecified Subject'</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2025-10-29 10:34:00+0000</td></tr><tr><td>Activity</td><td><span title="Codes:{http://fhir.tiro.health/CodeSystem/form-activity definition}, {http://fhir.tiro.health/CodeSystem/form-activity data-import}, {http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle originate}">Definition-based import</span></td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type assembler}">Assembler</span></td><td><a href="Device-atticus-population-engine.html">Device: displayName = Atticus Population Engine</a></td></tr></table></div>
  </text>
  <target>
    <extension url="http://hl7.org/fhir/StructureDefinition/targetElement">
      <valueUri value="item-444"/>
    </extension>
    <reference value="QuestionnaireResponse/qr-123"/>
  </target>
  <recorded value="2025-10-29T10:34:00Z"/>
  <activity>
    <coding>
      <system value="http://fhir.tiro.health/CodeSystem/form-activity"/>
      <code value="definition"/>
      <display value="Definition-based import"/>
    </coding>
    <coding>
      <system value="http://fhir.tiro.health/CodeSystem/form-activity"/>
      <code value="data-import"/>
      <display value="Data Import"/>
    </coding>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/iso-21089-lifecycle"/>
      <code value="originate"/>
      <display value="Originate/Retain Record Lifecycle Event"/>
    </coding>
  </activity>
  <agent>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
        <code value="assembler"/>
        <display value="Assembler"/>
      </coding>
    </type>
    <who>
      <reference value="Device/atticus-population-engine"/>
    </who>
  </agent>
  <entity>
    <role value="source"/>
    <what>
      <reference value="Observation/obs-789"/>
      <display value="Serum Creatinine Lab Result"/>
    </what>
  </entity>
</Provenance>