<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>
