臺灣牙醫實作指引 (Taiwan Dental Implementation Guide)
0.0.1 - ballot

臺灣牙醫實作指引 (Taiwan Dental Implementation Guide) - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Logical Model: TWDentalPeriodontalSelfPayConsentModel - XML Profile

Active as of 2025-06-10

XML representation of the TWDentalPeriodontalSelfPayConsent logical model.

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    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="TWDentalPeriodontalSelfPayConsent"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition TWDentalPeriodontalSelfPayConsent</b></p><a name="TWDentalPeriodontalSelfPayConsent"> </a><a name="hcTWDentalPeriodontalSelfPayConsent"> </a><a name="TWDentalPeriodontalSelfPayConsent-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent" title="此模型說明本 IG 如何定義牙周炎病人自費同意書的資料結構。">TWDentalPeriodontalSelfPayConsent</a><a name="TWDentalPeriodontalSelfPayConsent"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/types.html#Base">Base</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">牙周炎病人自費同意書 (TW Periodontal Self-Pay Consent) 之邏輯模型</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.patientName" title="病患姓名。">patientName</a><a name="TWDentalPeriodontalSelfPayConsent.patientName"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">姓名</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.birthDate" title="病患出生日期。">birthDate</a><a name="TWDentalPeriodontalSelfPayConsent.birthDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">出生日期</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.medicalRecordNumber" title="病患的病歷號碼。">medicalRecordNumber</a><a name="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">病歷號碼</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.organizationName" title="醫療機構名稱。">organizationName</a><a name="TWDentalPeriodontalSelfPayConsent.organizationName"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫院(診所)名稱</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentDescription" title="自費同意書說明內容。">consentDescription</a><a name="TWDentalPeriodontalSelfPayConsent.consentDescription"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">同意說明</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayReasons" title="自費原因（多選）。">selfPayReasons</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayReasons"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">自費原因<br/></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayOtherReason" title="其他自費原因說明。">selfPayOtherReason</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">其他自費原因</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayItems" title="自費項目明細列表。">selfPayItems</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayItems"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">自費項目明細<br/></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName" title="自費品項名稱。">itemName</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">品項名稱</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice" title="自費品項單價。">unitPrice</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">單價</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity" title="自費品項數量。">quantity</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#integer">integer</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">數量</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.selfPayItems.amount" title="自費品項自付金額。">amount</a><a name="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">自付金額</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.notes" title="附註條款內容。">notes</a><a name="TWDentalPeriodontalSelfPayConsent.notes"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">附註<br/></td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentPersonName" title="立同意書人姓名。">consentPersonName</a><a name="TWDentalPeriodontalSelfPayConsent.consentPersonName"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">立同意書人姓名</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentPersonId" title="立同意書人身分證統一編號。">consentPersonId</a><a name="TWDentalPeriodontalSelfPayConsent.consentPersonId"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">身分證統一編號</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentRelation" title="立同意書人與病人之關係。">consentRelation</a><a name="TWDentalPeriodontalSelfPayConsent.consentRelation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">與病人之關係</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.contactPhone" title="聯絡電話。">contactPhone</a><a name="TWDentalPeriodontalSelfPayConsent.contactPhone"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">聯絡電話</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.contactMobile" title="手機號碼。">contactMobile</a><a name="TWDentalPeriodontalSelfPayConsent.contactMobile"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">手機</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.contactAddress" title="通訊地址。">contactAddress</a><a name="TWDentalPeriodontalSelfPayConsent.contactAddress"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">通訊地址</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentSignature" title="立同意書人簽名。">consentSignature</a><a name="TWDentalPeriodontalSelfPayConsent.consentSignature"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Signature">Signature</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">簽名</td></tr>
    <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-TWDentalPeriodontalSelfPayConsent-definitions.html#TWDentalPeriodontalSelfPayConsent.consentDate" title="同意書簽署日期。">consentDate</a><a name="TWDentalPeriodontalSelfPayConsent.consentDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">同意日期</td></tr>
    <tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64, " alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
      </text>
      <url
           value="http://dental-ig.fhir.tw/StructureDefinition/TWDentalPeriodontalSelfPayConsent"/>
      <version value="0.0.1"/>
      <name value="TWDentalPeriodontalSelfPayConsentModel"/>
      <title value="牙周炎病人自費同意書 (TW Periodontal Self-Pay Consent) 之邏輯模型"/>
      <status value="active"/>
      <date value="2025-06-10T09:56:59+08:00"/>
      <publisher value="金屬工業研究發展中心"/>
      <contact>
        <name value="金屬工業研究發展中心"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.mirdc.org.tw/"/>
        </telecom>
      </contact>
      <contact>
        <name value="黃怡文"/>
        <telecom>
          <system value="email"/>
          <value value="lisaiwh@mail.mirdc.org.tw"/>
          <use value="work"/>
        </telecom>
      </contact>
      <contact>
        <name value="莊世任"/>
        <telecom>
          <system value="email"/>
          <value value="renjuang@mail.mirdc.org.tw"/>
          <use value="work"/>
        </telecom>
      </contact>
      <description value="此模型說明本 IG 如何定義牙周炎病人自費同意書的資料結構。"/>
      <fhirVersion value="4.0.1"/>
      <kind value="logical"/>
      <abstract value="false"/>
      <type
            value="http://dental-ig.fhir.tw/StructureDefinition/TWDentalPeriodontalSelfPayConsent"/>
      <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
      <derivation value="specialization"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="4.0.1"/>
        </extension>
        <element id="TWDentalPeriodontalSelfPayConsent">
          <path value="TWDentalPeriodontalSelfPayConsent"/>
          <short value="牙周炎病人自費同意書 (TW Periodontal Self-Pay Consent) 之邏輯模型"/>
          <definition value="此模型說明本 IG 如何定義牙周炎病人自費同意書的資料結構。"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Base"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <isModifier value="false"/>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.patientName">
          <path value="TWDentalPeriodontalSelfPayConsent.patientName"/>
          <short value="姓名"/>
          <definition value="病患姓名。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.patientName"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="HumanName"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.birthDate">
          <path value="TWDentalPeriodontalSelfPayConsent.birthDate"/>
          <short value="出生日期"/>
          <definition value="病患出生日期。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.birthDate"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber">
          <path value="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber"/>
          <short value="病歷號碼"/>
          <definition value="病患的病歷號碼。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Identifier"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.organizationName">
          <path value="TWDentalPeriodontalSelfPayConsent.organizationName"/>
          <short value="醫院(診所)名稱"/>
          <definition value="醫療機構名稱。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.organizationName"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentDescription">
          <path value="TWDentalPeriodontalSelfPayConsent.consentDescription"/>
          <short value="同意說明"/>
          <definition value="自費同意書說明內容。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentDescription"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayReasons">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayReasons"/>
          <short value="自費原因"/>
          <definition value="自費原因（多選）。"/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.selfPayReasons"/>
            <min value="1"/>
            <max value="*"/>
          </base>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason"/>
          <short value="其他自費原因"/>
          <definition value="其他自費原因說明。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems"/>
          <short value="自費項目明細"/>
          <definition value="自費項目明細列表。"/>
          <min value="1"/>
          <max value="*"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems"/>
            <min value="1"/>
            <max value="*"/>
          </base>
          <type>
            <code value="BackboneElement"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.id">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.extension">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element
                 id="TWDentalPeriodontalSelfPayConsent.selfPayItems.modifierExtension">
          <path
                value="TWDentalPeriodontalSelfPayConsent.selfPayItems.modifierExtension"/>
          <short value="Extensions that cannot be ignored even if unrecognized"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <requirements
                        value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <alias value="modifiers"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="BackboneElement.modifierExtension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="true"/>
          <isModifierReason
                            value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
          <isSummary value="true"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName"/>
          <short value="品項名稱"/>
          <definition value="自費品項名稱。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path
                  value="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice"/>
          <short value="單價"/>
          <definition value="自費品項單價。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path
                  value="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Money"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity"/>
          <short value="數量"/>
          <definition value="自費品項數量。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path
                  value="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="integer"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount"/>
          <short value="自付金額"/>
          <definition value="自費品項自付金額。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Money"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.notes">
          <path value="TWDentalPeriodontalSelfPayConsent.notes"/>
          <short value="附註"/>
          <definition value="附註條款內容。"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.notes"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentPersonName">
          <path value="TWDentalPeriodontalSelfPayConsent.consentPersonName"/>
          <short value="立同意書人姓名"/>
          <definition value="立同意書人姓名。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentPersonName"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="HumanName"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentPersonId">
          <path value="TWDentalPeriodontalSelfPayConsent.consentPersonId"/>
          <short value="身分證統一編號"/>
          <definition value="立同意書人身分證統一編號。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentPersonId"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentRelation">
          <path value="TWDentalPeriodontalSelfPayConsent.consentRelation"/>
          <short value="與病人之關係"/>
          <definition value="立同意書人與病人之關係。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentRelation"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactPhone">
          <path value="TWDentalPeriodontalSelfPayConsent.contactPhone"/>
          <short value="聯絡電話"/>
          <definition value="聯絡電話。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.contactPhone"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactMobile">
          <path value="TWDentalPeriodontalSelfPayConsent.contactMobile"/>
          <short value="手機"/>
          <definition value="手機號碼。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.contactMobile"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactAddress">
          <path value="TWDentalPeriodontalSelfPayConsent.contactAddress"/>
          <short value="通訊地址"/>
          <definition value="通訊地址。"/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.contactAddress"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentSignature">
          <path value="TWDentalPeriodontalSelfPayConsent.consentSignature"/>
          <short value="簽名"/>
          <definition value="立同意書人簽名。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentSignature"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="Signature"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentDate">
          <path value="TWDentalPeriodontalSelfPayConsent.consentDate"/>
          <short value="同意日期"/>
          <definition value="同意書簽署日期。"/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="TWDentalPeriodontalSelfPayConsent.consentDate"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <code value="date"/>
          </type>
        </element>
      </snapshot>
      <differential>
        <element id="TWDentalPeriodontalSelfPayConsent">
          <path value="TWDentalPeriodontalSelfPayConsent"/>
          <short value="牙周炎病人自費同意書 (TW Periodontal Self-Pay Consent) 之邏輯模型"/>
          <definition value="此模型說明本 IG 如何定義牙周炎病人自費同意書的資料結構。"/>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.patientName">
          <path value="TWDentalPeriodontalSelfPayConsent.patientName"/>
          <short value="姓名"/>
          <definition value="病患姓名。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="HumanName"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.birthDate">
          <path value="TWDentalPeriodontalSelfPayConsent.birthDate"/>
          <short value="出生日期"/>
          <definition value="病患出生日期。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="date"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber">
          <path value="TWDentalPeriodontalSelfPayConsent.medicalRecordNumber"/>
          <short value="病歷號碼"/>
          <definition value="病患的病歷號碼。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="Identifier"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.organizationName">
          <path value="TWDentalPeriodontalSelfPayConsent.organizationName"/>
          <short value="醫院(診所)名稱"/>
          <definition value="醫療機構名稱。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentDescription">
          <path value="TWDentalPeriodontalSelfPayConsent.consentDescription"/>
          <short value="同意說明"/>
          <definition value="自費同意書說明內容。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayReasons">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayReasons"/>
          <short value="自費原因"/>
          <definition value="自費原因（多選）。"/>
          <min value="1"/>
          <max value="*"/>
          <type>
            <code value="CodeableConcept"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayOtherReason"/>
          <short value="其他自費原因"/>
          <definition value="其他自費原因說明。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems"/>
          <short value="自費項目明細"/>
          <definition value="自費項目明細列表。"/>
          <min value="1"/>
          <max value="*"/>
          <type>
            <code value="BackboneElement"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.itemName"/>
          <short value="品項名稱"/>
          <definition value="自費品項名稱。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.unitPrice"/>
          <short value="單價"/>
          <definition value="自費品項單價。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="Money"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.quantity"/>
          <short value="數量"/>
          <definition value="自費品項數量。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="integer"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount">
          <path value="TWDentalPeriodontalSelfPayConsent.selfPayItems.amount"/>
          <short value="自付金額"/>
          <definition value="自費品項自付金額。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="Money"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.notes">
          <path value="TWDentalPeriodontalSelfPayConsent.notes"/>
          <short value="附註"/>
          <definition value="附註條款內容。"/>
          <min value="0"/>
          <max value="*"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentPersonName">
          <path value="TWDentalPeriodontalSelfPayConsent.consentPersonName"/>
          <short value="立同意書人姓名"/>
          <definition value="立同意書人姓名。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="HumanName"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentPersonId">
          <path value="TWDentalPeriodontalSelfPayConsent.consentPersonId"/>
          <short value="身分證統一編號"/>
          <definition value="立同意書人身分證統一編號。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentRelation">
          <path value="TWDentalPeriodontalSelfPayConsent.consentRelation"/>
          <short value="與病人之關係"/>
          <definition value="立同意書人與病人之關係。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactPhone">
          <path value="TWDentalPeriodontalSelfPayConsent.contactPhone"/>
          <short value="聯絡電話"/>
          <definition value="聯絡電話。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactMobile">
          <path value="TWDentalPeriodontalSelfPayConsent.contactMobile"/>
          <short value="手機"/>
          <definition value="手機號碼。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.contactAddress">
          <path value="TWDentalPeriodontalSelfPayConsent.contactAddress"/>
          <short value="通訊地址"/>
          <definition value="通訊地址。"/>
          <min value="0"/>
          <max value="1"/>
          <type>
            <code value="string"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentSignature">
          <path value="TWDentalPeriodontalSelfPayConsent.consentSignature"/>
          <short value="簽名"/>
          <definition value="立同意書人簽名。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="Signature"/>
          </type>
        </element>
        <element id="TWDentalPeriodontalSelfPayConsent.consentDate">
          <path value="TWDentalPeriodontalSelfPayConsent.consentDate"/>
          <short value="同意日期"/>
          <definition value="同意書簽署日期。"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="date"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>