| (0008,0005) | Specific Character Set | CS | 1 | ISO_IR 100 |
| (0008,0050) | Accession Number | SH | 1 | 00000187 |
| (0008,0090) | Referring Physician's Name | PN | 1 | Chief Radiologist^First^Middle^^ |
| (0008,1110) | Referenced Study Sequence | SQ | 1 | |
| >BEGIN ITEM 1 | | | | |
| >(0008,1150) | Referenced SOP Class UID | UI | 1 | 1.2.840.10008.3.1.2.1.1 |
| >(0008,1155) | Referenced SOP Instance UID | UI | 1 | 1.3.46.670589.16.12.2.1.176.53460.62132.20070126.102459.1 |
| >END ITEM 1 | | | | |
| (0010,0010) | Patient's Name | PN | 1 | One^Secondary Capture Image |
| (0010,0020) | Patient ID | LO | 1 | pidP645 |
| (0010,0021) | Issuer of Patient ID | LO | 1 | QREmulator |
| (0010,0030) | Patient's Birth Date | DA | 1 | 19800716 |
| (0010,0040) | Patient's Sex | CS | 1 | M |
| (0010,1000) | Other Patient IDs | LO | 0 | |
| (0010,1020) | Patient's Size | DS | 1 | 186 |
| (0010,1030) | Patient's Weight | DS | 1 | 80 |
| (0010,2000) | Medical Alerts | LO | 1 | MT |
| (0010,2110) | Allergies | LO | 0 | |
| (0010,2160) | Ethnic Group | SH | 1 | E1 |
| (0010,21b0) | Additional Patient History | LT | 0 | |
| (0010,21c0) | Pregnancy Status | US | 1 | 4 |
| (0010,4000) | Patient Comments | LT | 0 | |
| (0020,000d) | Study Instance UID | UI | 1 | 1.3.46.670589.16.12.2.1.176.53460.62132.20070126.102459.1 |
| (0032,1032) | Requesting Physician | PN | 1 | Chief Radiologist^First^Middle^^ |
| (0032,1033) | Requesting Service | LO | 1 | WARD1 |
| (0032,1060) | Requested Procedure Description | LO | 1 | CSPINE |
| (0032,1064) | Requested Procedure Code Sequence | SQ | 1 | |
| >BEGIN ITEM 1 | | | | |
| >(0008,0100) | Code Value | SH | 1 | CSPINE L BOTH |
| >(0008,0102) | Coding Scheme Designator | SH | 1 | QREmulator |
| >(0008,0103) | Coding Scheme Version | SH | 0 | |
| >(0008,0104) | Code Meaning | LO | 1 | CSPINE |
| >END ITEM 1 | | | | |
| (0038,0050) | Special Needs | LO | 0 | |
| (0038,0300) | Current Patient Location | LO | 0 | |
| (0040,0100) | Scheduled Procedure Step Sequence | SQ | 1 | |
| >BEGIN ITEM 1 | | | | |
| >(0008,0060) | Modality | CS | 1 | MA |
| >(0032,1070) | Requested Contrast Agent | LO | 0 | |
| >(0040,0001) | Scheduled Station AE Title | AE | 1 | FILMDIGITIZE |
| >(0040,0002) | Scheduled Procedure Step Start Date | DA | 1 | 20070126 |
| >(0040,0003) | Scheduled Procedure Step Start Time | TM | 1 | 113500 |
| >(0040,0004) | Scheduled Procedure Step End Date | DA | 0 | |
| >(0040,0005) | Scheduled Procedure Step End Time | TM | 0 | |
| >(0040,0006) | Scheduled Performing Physician's Name | PN | 0 | |
| >(0040,0007) | Scheduled Procedure Step Description | LO | 1 | CSPINE |
| >(0040,0008) | Scheduled Protocol Code Sequence | SQ | 1 | |
| >>BEGIN ITEM 1 | | | | |
| >>(0008,0100) | Code Value | SH | 1 | CSPINE L BOTH |
| >>(0008,0102) | Coding Scheme Designator | SH | 1 | EASYRIS |
| >>(0008,0104) | Code Meaning | LO | 1 | CSPINE |
| >>END ITEM 1 | | | | |
| >(0040,0009) | Scheduled Procedure Step ID | SH | 1 | 0000018706 |
| >(0040,0010) | Scheduled Station Name | SH | 1 | FILMDIGITIZE |
| >(0040,0011) | Scheduled Procedure Step Location | SH | 1 | FILMDIGITIZE |
| >(0040,0012) | Pre-Medication | LO | 0 | |
| >(0040,0020) | Scheduled Procedure Step Status | CS | 1 | SC |
| >(0040,0400) | Comments on the Scheduled Procedure Step | LT | 1 | h |
| >END ITEM 1 | | | | |
| (0040,1001) | Requested Procedure ID | SH | 1 | 0000018705 |
| (0040,1002) | Reason for the Requested Procedure | LO | 0 | |
| (0040,1003) | Requested Procedure Priority | SH | 1 | N |
| (0040,1004) | Patient Transport Arrangements | LO | 1 | CART |
| (0040,1010) | Names of Intended Recipients of Results | PN | 0 | |
| (0040,1400) | Requested Procedure Comments | LT | 0 | |
| (0040,2001) | Reason for the Imaging Service Request (retired) | LO | 0 | |
| (0040,2004) | Issue Date of Imaging Service Request | DA | 1 | 20070126 |
| (0040,2400) | Imaging Service Request Comments | LT | 1 | ewe^^^^^^^^^^eqwew |
| (0040,3001) | Confidentiality Constraint on Patient Data Description | LO | 1 | U |