NP Core Clinical Document Reference

Sets minimum expectations for referencing a clinical document (such as a discharge summary, progress note, or referral letter) within the NP Core context.

Open in IG ↗

Canonical URL: http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-clinical-documentreference
Resource / type: DocumentReference
Based on: http://hl7.org/fhir/StructureDefinition/DocumentReference
Claim conformance: Put the canonical URL in meta.profile of each instance.

Required elements

“Always” means the element must be present in every instance. Otherwise it is required only when its parent element is present.

Element	Card.	When
`DocumentReference.status` current \| superseded \| entered-in-error	1..1	Always
`DocumentReference.type` Kind of document (LOINC if possible)	1..1	Always
`DocumentReference.relatesTo.code` replaces \| transforms \| signs \| appends	1..1	If parent present
`DocumentReference.relatesTo.target` Target of the relationship	1..1	If parent present
`DocumentReference.content` Document referenced	1..*	Always
`DocumentReference.content.attachment` Where to access the document	1..1	Always

Must-support elements

If your system has this data it SHALL send it, and receivers SHALL process it. Must-support does not by itself make an element mandatory.

DocumentReference.status
DocumentReference.type
DocumentReference.subject
DocumentReference.author
DocumentReference.custodian
DocumentReference.content
DocumentReference.content.attachment

Terminology bindings

required: codes SHALL come from the value set · extensible: use the value set if a suitable code exists · preferred / example: guidance only.

Element	Strength	Value set
`DocumentReference.language`	preferred	http://hl7.org/fhir/ValueSet/languages
`DocumentReference.status`	required	http://hl7.org/fhir/ValueSet/document-reference-status
`DocumentReference.docStatus`	required	http://hl7.org/fhir/ValueSet/composition-status
`DocumentReference.type`	extensible	Clinical Document Type `18842-5` Discharge summary, `11488-4` Consult Note, `34117-2` History and Physical Note, `11506-3` Progress Note, `28570-0` Procedure Note, `18748-4` Diagnostic Imaging Study, `11502-2` Laboratory Report, `11526-1` Pathology Study, `11504-8` Surgical operation note, `34111-5` Emergency Department Note, `57133-1` Referral note http://fhir.digitalhealth.gov.np/core/ValueSet/clinical-document-type-vs
`DocumentReference.category`	example	http://hl7.org/fhir/ValueSet/document-classcodes
`DocumentReference.relatesTo.code`	required	http://hl7.org/fhir/ValueSet/document-relationship-type
`DocumentReference.securityLabel`	extensible	http://hl7.org/fhir/ValueSet/security-labels
`DocumentReference.content.format`	preferred	http://hl7.org/fhir/ValueSet/formatcodes
`DocumentReference.context.event`	example	http://terminology.hl7.org/ValueSet/v3-ActCode
`DocumentReference.context.facilityType`	example	http://hl7.org/fhir/ValueSet/c80-facilitycodes
`DocumentReference.context.practiceSetting`	example	http://hl7.org/fhir/ValueSet/c80-practice-codes

Official examples

DocumentReference/ExampleNPCoreClinicalDocumentReference

View in IG ↗

{
  "resourceType": "DocumentReference",
  "id": "ExampleNPCoreClinicalDocumentReference",
  "meta": {
    "profile": [
      "http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-clinical-documentreference"
    ]
  },
  "status": "current",
  "type": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "18842-5",
        "display": "Discharge summary"
      }
    ]
  },
  "subject": {
    "reference": "Patient/ExampleNPCorePatient"
  },
  "date": "2026-05-10T15:00:00+05:45",
  "author": [
    {
      "reference": "Practitioner/ExampleNPCorePractitioner"
    }
  ],
  "custodian": {
    "reference": "Organization/ExampleNPCoreOrganization"
  },
  "content": [
    {
      "attachment": {
        "contentType": "application/pdf",
        "language": "en",
        "title": "Discharge Summary — Aarav Shrestha — 2026-05-10",
        "creation": "2026-05-10T15:00:00+05:45"
      }
    }
  ],
  "context": {
    "encounter": [
      {
        "reference": "Encounter/ExampleNPCoreEncounter"
      }
    ]
  }
}

Narrative (text) removed for readability.