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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Dear colleague, I am writing to inform you about the hospital course of your patient, a 32-year-old male, admitted on 05/08/2020 due to confirmed SARS-CoV-2 infection. On admission, the patient presented with fever, dry cough, dyspnoea, and reduced oxygen saturation. PCR testing confirmed COVID-19. Chest X-ray and CT thorax demonstrated bilateral ground-glass opacities consistent with COVID-19 pneumonia. The patient was treated with supplemental oxygen therapy, dexamethasone, and supportive measures including fluid management and antipyretics. Prone positioning was applied during periods of desaturation. No mechanical ventilation was required. Inflammatory markers peaked early and subsequently declined. The patient showed steady clinical improvement and was discharged on 19/08/2020 in stable condition with oxygen saturation within normal limits on room air. Please arrange follow-up including repeat chest imaging in 6 weeks. Further pulmonary function testing may be warranted.</div>"
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                  "system": "http://loinc.org",
                  "code": "8648-8",
                  "display": "Hospital course note"
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            "title": "Hospital course note"
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              "status": "generated",
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                  "code": "11535-2",
                  "display": "Hospital discharge diagnosis note"
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              ]
            },
            "title": "Diagnosis at Discharge"
          },
          {
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__hdr\"><tr><td>Plain X-ray of chest (procedure)</td><td><span class=\"nb\">05-Aug-2020</span></td><td>-</td></tr></table></div>"
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                "reference": "urn:uuid:b3e63081-c630-4a6a-8121-11b5248521c8"
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              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "10185-7",
                  "display": "Hospital discharge procedure note"
                }
              ]
            },
            "title": "Significant procedures"
          },
          {
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__hdr\"><tr><td>Body temperature</td><td>20-Aug-2020</td><td>-</td></tr></table></div>"
            },
            "entry": [
              {
                "reference": "urn:uuid:9fc39969-add2-416c-96af-1a4821373b2a"
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            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "8716-3",
                  "display": "Vital signs note"
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              ]
            },
            "title": "Vital Signs during Stay"
          }
        ],
        "title": "Hospital Discharge Report",
        "status": "final",
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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        "custodian": {
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        "date": "2020-08-19T00:00:00Z",
        "confidentiality": "N"
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      "fullUrl": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
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        "resourceType": "Patient",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
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            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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          ],
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            {
              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
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        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "code": "JHN",
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              ]
            },
            "system": "http://ec.europa.eu/identifier/eci",
            "value": "4997-839776-5"
          },
          {
            "type": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
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              ]
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            "system": "http://local.setting.eu/identifier",
            "value": "33b3083e-07fa-9896-03e0-5aa9634ffd56"
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        ],
        "name": [
          {
            "given": [
              "Nicolas"
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            "family": "Chauvin",
            "text": "Nicolas Chauvin"
          }
        ],
        "address": [
          {
            "line": [
              "55, rue Sophie Launay"
            ],
            "use": "home",
            "type": "physical",
            "postalCode": "71580",
            "city": "Riou-sur-Salmon",
            "country": "France"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "+33 7 83 01 24 29"
          }
        ],
        "extension": [
          {
            "extension": [
              {
                "url": "code",
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                  "coding": [
                    {
                      "code": "FR",
                      "system": "urn:iso:std:iso:3166"
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Nicolas Chauvin</td><td>male</td><td>24-Jan-1993</td></tr></table></div>"
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          {
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                "coding": [
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                    "code": "PPRF",
                    "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                    "display": "primary performer"
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                ]
              }
            ],
            "period": {
              "end": "2020-08-19"
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              "reference": "urn:uuid:9419f5aa-afe7-4ccd-bb8e-bc001f647188"
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        "reasonCode": [
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                "system": "http://snomed.info/sct",
                "display": "Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)"
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            ]
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Centre Hospitalier de Belleville, Belleville-en-Beaujolais, France</td><td>05-08-2020 - 19-08-2020</td><td><ul><li>Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)</li></ul></td></tr></table></div>"
        },
        "status": "completed",
        "class": {
          "code": "IMP",
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode"
        },
        "serviceProvider": {
          "reference": "urn:uuid:f9f8f6e5-c014-473c-89a4-e92867f34b02"
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        "subject": {
          "reference": "Patient/c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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      "fullUrl": "urn:uuid:5f3f7c93-4e10-4930-b594-762fc5144bce",
      "resource": {
        "resourceType": "PractitionerRole",
        "id": "5f3f7c93-4e10-4930-b594-762fc5144bce",
        "meta": {
          "profile": [
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        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital Role Id: 5f3f7c93-4e10-4930-b594-762fc5144bce</div>"
        },
        "practitioner": {
          "reference": "urn:uuid:9419f5aa-afe7-4ccd-bb8e-bc001f647188"
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        "organization": {
          "reference": "urn:uuid:f9f8f6e5-c014-473c-89a4-e92867f34b02"
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    {
      "fullUrl": "urn:uuid:f9f8f6e5-c014-473c-89a4-e92867f34b02",
      "resource": {
        "resourceType": "Organization",
        "id": "f9f8f6e5-c014-473c-89a4-e92867f34b02",
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          "profile": [
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        "address": [
          {
            "city": "Belleville-en-Beaujolais",
            "postalCode": "69220",
            "country": "France"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital: Centre Hospitalier de Belleville, 69220 Belleville-en-Beaujolais, France</div>"
        },
        "name": "Centre Hospitalier de Belleville"
      }
    },
    {
      "fullUrl": "urn:uuid:9419f5aa-afe7-4ccd-bb8e-bc001f647188",
      "resource": {
        "resourceType": "Practitioner",
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          "profile": [
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        },
        "identifier": [
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            "assigner": {
              "display": "HL7 Europe"
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            "system": "urn:oid:2.16.840.1.113883.2.51.999",
            "value": "c1f5cf83-f35d-477e-be4f-8503e63d607a"
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        ],
        "name": [
          {
            "given": [
              "Monique"
            ],
            "family": "Julien"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Practitioner in Hospital: Monique Julien</div>"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:6c076881-a259-4778-bc06-7a876d0df9ed",
      "resource": {
        "resourceType": "Condition",
        "id": "6c076881-a259-4778-bc06-7a876d0df9ed",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/condition-eu-core"
          ]
        },
        "category": [
          {
            "coding": [
              {
                "code": "encounter-diagnosis",
                "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                "display": "Encounter Diagnosis"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "code": "U07.1",
              "system": "http://hl7.org/fhir/sid/icd-10",
              "display": "COVID-19, virus identified"
            }
          ],
          "text": "COVID-19, virus identified"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>COVID-19, virus identified</td><td><span class=\"nb\">19-Aug-2020</span></td><td>active</td></tr></table></div>"
        },
        "onsetDateTime": "2020-08-19",
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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    {
      "fullUrl": "urn:uuid:025400f7-c1db-4778-941d-1d51680e76cd",
      "resource": {
        "resourceType": "Procedure",
        "id": "025400f7-c1db-4778-941d-1d51680e76cd",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
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        },
        "code": {
          "coding": [
            {
              "code": "371908008",
              "system": "http://snomed.info/sct",
              "display": "Oxygen administration by mask"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Oxygen administration by mask (procedure)</td><td><span class=\"nb\">19-Aug-2020</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "2020-08-19",
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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    {
      "fullUrl": "urn:uuid:b3e63081-c630-4a6a-8121-11b5248521c8",
      "resource": {
        "resourceType": "Procedure",
        "id": "b3e63081-c630-4a6a-8121-11b5248521c8",
        "meta": {
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        "code": {
          "coding": [
            {
              "code": "431182000",
              "system": "http://snomed.info/sct",
              "display": "Placing subject in prone position"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Placing subject in prone position (procedure)</td><td><span class=\"nb\">19-Aug-2020</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "2020-08-19",
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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      }
    },
    {
      "fullUrl": "urn:uuid:56d839c2-bbb0-4aa8-8761-fcb933bf614e",
      "resource": {
        "resourceType": "Procedure",
        "id": "56d839c2-bbb0-4aa8-8761-fcb933bf614e",
        "meta": {
          "profile": [
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        },
        "code": {
          "coding": [
            {
              "code": "399208008",
              "system": "http://snomed.info/sct",
              "display": "Plain X-ray of chest"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Plain X-ray of chest (procedure)</td><td><span class=\"nb\">05-Aug-2020</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "2020-08-05",
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
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      }
    },
    {
      "fullUrl": "urn:uuid:9fc39969-add2-416c-96af-1a4821373b2a",
      "resource": {
        "resourceType": "Observation",
        "id": "9fc39969-add2-416c-96af-1a4821373b2a",
        "meta": {
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/vitalsigns"
          ]
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                "code": "vital-signs",
                "display": "Vital Signs"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><th>Vital Sign</th><th>Date</th><th>Measurement</th></tr><tr><td>Body temperature</td><td>20-Aug-2020</td><td>-</td></tr></table></div>"
        },
        "status": "final",
        "code": {
          "coding": [
            {
              "code": "8310-5",
              "system": "http://loinc.org",
              "display": "Body temperature"
            }
          ]
        },
        "subject": {
          "reference": "urn:uuid:c9c1f7c4-3c63-483f-babc-f5a50b87fd59",
          "display": "Nicolas Chauvin"
        },
        "effectiveDateTime": "2020-08-20"
      }
    },
    {
      "fullUrl": "urn:uuid:519b86a0-228a-42e7-8f56-2f7b9375343c",
      "resource": {
        "resourceType": "Device",
        "id": "519b86a0-228a-42e7-8f56-2f7b9375343c",
        "deviceName": [
          {
            "name": "SYNDERAI Synthetic Generator",
            "type": "manufacturer-name"
          }
        ],
        "version": [
          {
            "value": "5.0"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">SYNDERAI Synthetic Generator v5.0</div>"
        },
        "status": "active",
        "distinctIdentifier": "synderai-generator-50",
        "manufacturer": "SYNDERAI Project"
      }
    },
    {
      "fullUrl": "urn:uuid:2c9dbd00-a1df-4e7a-969f-4e0e2fe7b9f1",
      "resource": {
        "resourceType": "Provenance",
        "id": "2c9dbd00-a1df-4e7a-969f-4e0e2fe7b9f1",
        "target": [
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          {
            "reference": "urn:uuid:5f3f7c93-4e10-4930-b594-762fc5144bce"
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          {
            "reference": "urn:uuid:9419f5aa-afe7-4ccd-bb8e-bc001f647188"
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          {
            "reference": "urn:uuid:f9f8f6e5-c014-473c-89a4-e92867f34b02"
          }
        ],
        "activity": {
          "coding": [
            {
              "code": "CREATE",
              "system": "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
              "display": "create"
            }
          ],
          "text": "Synthetic Example Data Generation"
        },
        "policy": [
          "https://synderai.net/synderai-synthetic-data-policy"
        ],
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "code": "author",
                  "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                  "display": "Author"
                }
              ],
              "text": "author"
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            "who": {
              "reference": "urn:uuid:519b86a0-228a-42e7-8f56-2f7b9375343c"
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        ],
        "reason": [
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            "coding": [
              {
                "code": "TRAIN",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
                "display": "training"
              }
            ],
            "text": "Interoperability Testing and Training (non-clinical use)"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provenance for SYNDERAI Synthetic Example Data Resource</div>"
        },
        "recorded": "2026-03-20T18:17:50Z"
      }
    }
  ],
  "type": "document",
  "timestamp": "2020-08-19T00:00:00Z"
}