| 69434-9 | Location of death name:ID:Pt:Facility:Nom: | |
| 69435-6 | Street address where death occurred if not facility:Addr:Pt:Facility:Nom: | |
| 74499-5 | Death pronouncer:Find:Pt:Provider:Doc: | |
| 80616-6 | Date and time pronounced dead:TmStp:Pt:^Patient:Qn:US standard certificate of death | |
| 31211-6 | Date of death | |
| 69454-7 | Death date comment:Find:Pt:^Patient:Nar: | |
| 74497-9 | Medical examiner or coroner was contacted:Find:Pt:^Patient:Ord:US standard certificate of death | |
| 69453-9 | Cause of death:Find:Pt:^Patient:Nom:US standard certificate of death | |
| 69440-6 | Disease onset to death interval:Find:Pt:^Patient:Nar: | |
| 69441-4 | Other significant causes or conditions of death:Hx:Pt:^Patient:Nar: | required |
| 80905-3 | Body disposition method:Type:Pt:^Patient:Nom: | |
| 69436-4 | Autopsy results available:Find:Pt:^Patient:Ord: | |
| 69443-0 | Did tobacco use contribute to death:Find:Pt:^Patient:Ord: | |
| 69442-2 | Timing of recent pregnancy in relation to death:Hx:Pt:^Patient:Ord: | |
| 69449-7 | Manner of death:Type:Pt:^Patient:Nom: | |
| 71481-6 | Did the death of this person involve injury of any kind:Find:Pt:^Patient:Ord: | |
| 69445-5 | Injury date:Date:Pt:^Patient:Qn: | conditional |
| 69446-3 | Injury date comment:Txt:Pt:^Patient:Nar: | conditional |
| 69450-5 | Place of injury:Type:Pt:Facility:Nar: | conditional |
| 69444-8 | Did death result from injury at work:Find:Pt:^Patient:Ord: | |
| 69447-1 | Injury location:Addr:Pt:^Patient:Nar: | conditional |
| 11374-6 | Injury incident description | conditional |
| 69448-9 | Injury leading to death associated with transportation event:Find:Pt:^Patient:Ord: | conditional |
| 69451-3 | Transportation role of decedent:Find:Pt:^Patient:Nom: | |
| 74734-5 | Death certifier details:Find:Pt:Provider:Doc: | |
| 69437-2 | Death certifier:Type:Pt:Provider:Nom: | |
| 69439-8 | Death certifier:Addr:Pt:Provider:Nom: | |
| 69452-1 | Coroner - medical examiner case number:Find:Pt:^Patient:Nom: | |
| 21843-8 | Hx of Usual occupation | |
| 21844-6 | Hx of Usual industry | |
| 80913-7 | Highest level of education:Hx:Pt:^Patient:Ord:US standard certificate of death | |
| 69438-0 | Forensic medicine Referral note | |
| 86345-6 | U.S. Death cert 2003 set | |