<entry>

<observation classCode="OBS" moodCode="EVN">
  <!-- C-CDA R2.1 Deceased Observation (V3) templateId -->
  <templateId root="2.16.840.1.113883.10.20.22.4.79" extension="2015-08-01" />
  <!-- Patient Characteristic Expired (V3) -->
  <templateId root="2.16.840.1.113883.10.20.24.3.54" extension="2016-02-01" />
  <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
  <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4" codeSystemName="HL7ActCode" />
  <statusCode code="completed" />
  {{#expiredDatetime}}
    <!-- QDM Attributes: expiredDatetime  -->
    {{{expired_date_time}}}
  {{/expiredDatetime}}
  <value xsi:type="CD" code="419099009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Dead" />
  {{#cause}}
    <!-- QDM Attribute: Cause -->
    <entryRelationship typeCode="CAUS" negationInd="false">
      <observation classCode="OBS" moodCode="EVN">
        <!-- C-CDA R2.1 Problem Observation (V3) -->
        <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01" />
        <id root="{{random_id}}"/>
        <code code="64572001" displayName="Condition" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
          <translation code="75323-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Condition"/>
        </code>
        <statusCode code="completed" />
        {{{expired_date_time}}}
        <value {{> _code}} xsi:type="CD"/>
      </observation>
    </entryRelationship>
  {{/cause}}
</observation>

</entry>