<model xmlns="http://www.w3.org/2002/xforms"><instance>
        <hospital id="EDCD_H01" version="2015-06-17">
          <report_date tag="date"/>
          <select_facility tag="hs"/>
          <group_facility>
            <facility_code_list tag="hf"/>
            <facility_code_other tag="hfo"/>
            <facility_code tag="hfc"/>
          </group_facility>
          <group_all_treated>
            <opd_patients_under_five tag="au5"/>
            <opd_patients_five_over tag="a5o"/>
          </group_all_treated>
          <group_influenza>
            <influenza_under_five tag="iu5"/>
            <influenza_five_over tag="i5o"/>
          </group_influenza>
          <group_respiratory>
            <respiratory_under_five tag="ru5"/>
            <respiratory_five_over tag="r5o"/>
          </group_respiratory>
          <group_watery_diarrhoea>
            <watery_diarrhoea_under_five tag="wu5"/>
            <watery_diarrhoea_five_over tag="w5o"/>
          </group_watery_diarrhoea>
          <group_bloody_diarrhoea>
            <bloody_diarrhoea_under_five tag="bu5"/>
            <bloody_diarrhoea_five_over tag="b5o"/>
            <suspected_cholera tag="c5o"/>
          </group_bloody_diarrhoea>
          <group_fever_jaundice>
            <fever_jaundice_under_five tag="fju5"/>
            <fever_jaundice_five_over tag="fj5o"/>
          </group_fever_jaundice>
          <group_fever_rash>
            <fever_rash_under_five tag="fru5"/>
            <fever_rash_five_over tag="fr5o"/>
          </group_fever_rash>
          <group_fever_other>
            <fever_other_under_five tag="fou5"/>
            <fever_other_five_over tag="fo5o"/>
          </group_fever_other>
          <note_outbreak/>
          <phonenumber/>
          <imei/>
          <subscriberID/>
          <start/>
          <end/>
          <meta>
            <start tag="m_st"/>
            <end tag="m_et"/>
            <deviceID tag="m_d"/>
            <subscriberID tag="m_s"/>
            <phonenumber tag="m_p"/>
            <instanceID tag="m_i"/>
            <instanceName tag="m_n"/>
          </meta>
        </hospital>
      </instance></model>
