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<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" classCode="DOCCLIN" moodCode="EVN">
	<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040" assigningAuthorityName="HL7"/>
	<id assigningAuthorityName="MUW DiabetesAmbulanz" extension="200811112122.ao.Univ.Prof.Dr.M.Bischof" root="2.16.840.1.113883.5.25"/>
	<code displayName="Admission diagnosis" codeSystem="2.16.840.1.113883.6.1" code="42347-5"/>
	<title representation="TXT" mediaType="text/plain">TeleDiab: Anamnese- und Therapiedaten</title>
	<effectiveTime value="200811112122"/>
	<confidentialityCode codeSystem="2.16.840.1.113883.5.25" code="N"/>
	<recordTarget typeCode="RCT">
		<patientRole classCode="PAT">
			<id root="2.16.840.1.113883.5.25" assigningAuthorityName="MUW" extension="123456"/>
			<id root="2.16.840.1.113883.5.25" assigningAuthorityName="Sozialversicherungsnummer" extension="654321"/>
			<addr>
				<streetAddressLine>Straße 123</streetAddressLine>
				<postalCode>123</postalCode>
				<city>Ort, Bundesland</city>
				<country>A</country>
			</addr>
			<telecom value="tel:1234/123123"/>
			<telecom value="false"/>
			<patient determinerCode="INSTANCE" classCode="PSN">
				<name>
					<given>Vorname</given>
					<family>Nachname</family>
				</name>
				<administrativeGenderCode codeSystem="2.16.840.1.113883.5.1" code="F"/>
				<birthTime value="19000101"/>
			</patient>
		</patientRole>
	</recordTarget>
	<author typeCode="AUT" contextControlCode="OP">
		<time value="200811112122"/>
		<assignedAuthor classCode="ASSIGNED">
			<id assigningAuthorityName="MUW DiabetesAmbulanz" root="2.16.840.1.113883.5.25"/>
			<assignedPerson determinerCode="INSTANCE" classCode="PSN">
				<name>
					<given>ao.Univ.Prof.Dr.Arzt</given>
				</name>
			</assignedPerson>
		</assignedAuthor>
	</author>
	<custodian typeCode="CST">
		<assignedCustodian classCode="ASSIGNED">
			<representedCustodianOrganization classCode="ORG" determinerCode="INSTANCE">
				<id root="2.16.840.1.113883.5.25" extension="MUW DiabetesAmbulanz"/>
				<name>MUW </name>
				<addr>
					<streetAddressLine>Währinger Gürtel 18-20</streetAddressLine>
					<postalCode>1090</postalCode>
					<city>Wien</city>
					<country>Österreich</country>
				</addr>
			</representedCustodianOrganization>
		</assignedCustodian>
	</custodian>
	<component typeCode="COMP">
		<structuredBody classCode="DOCBODY" moodCode="EVN">
			<component typeCode="COMP" contextConductionInd="true">
				<section>
					<code code="10164-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" codeSystemVersion="2008" displayName="Jetzige Anamnese"/>
					<title>Anamnesedaten</title>
					<component typeCode="COMP">
						<section classCode="DOCSECT" moodCode="EVN">
							<code code="1" codeSystem="2.16.840.1.113883.2.16.3.1.2.5" codeSystemName="CDA4Diab" codeSystemVersion="1" displayName="Erstbesuch"/>
							<title>Erstbesuch</title>
							<text>
								<table>
									<thead>
										<tr>
											<th>Datum</th>
											<th>Uhrzeit</th>
											<th>Blutzucker</th>
											<!--<th>Mischinsulin</th>
											<th>Basalinsulin</th>
											<th>Korrekturinsulin</th>
											<th>Broteinheiten</th>
											<th>Körpergewicht</th>
											<th>Blutdruck systolisch</th>
											<th>Blutdruck diastolisch</th>-->
										</tr>
									</thead>
									<tbody>
										<tr>
											<td>20080101</td>
											<td>1600</td>
											<td>120</td>
										</tr>
										<tr>
											<td>20080101</td>
											<td>1700</td>
											<td>140</td>
										</tr>
										<tr>
											<td>20080101</td>
											<td>1800</td>
											<td>120</td>
										</tr>
										<tr>
											<td>20080102</td>
											<td>1600</td>
											<td>110</td>
										</tr>
										<tr>
											<td>20080102</td>
											<td>1700</td>
											<td>130</td>
										</tr>
										<tr>
											<td>20080102</td>
											<td>1800</td>
											<td>130</td>
										</tr>
									</tbody>
								</table>
							</text>
						</section>
					</component>
				</section>
			</component>
		</structuredBody>
	</component>
</ClinicalDocument>
