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              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Acute appendicitis, appendectomy performed</div>"
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              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Dear colleague, I am writing to inform you regarding your patient, a 40-year-old female, admitted on 20/08/1987 with acute right iliac fossa pain, nausea, and low-grade fever. Clinical examination revealed rebound tenderness at McBurney's point. Laboratory investigations confirmed leukocytosis, and abdominal ultrasound supported the diagnosis of acute appendicitis. The patient underwent an uncomplicated open appendectomy on 21/08/1987. Histopathological examination confirmed acute appendicitis. Postoperative recovery was uneventful. The patient received perioperative antibiotic prophylaxis and adequate analgesia. She was mobilised early and tolerated oral intake well. Wound healing was satisfactory at discharge on 23/08/1987. Please ensure appropriate wound care and suture removal in approximately 10 days. Return to normal activities expected within 4–6 weeks. Please do not hesitate to contact us should any concerns arise.</div>"
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              "coding": [
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                  "system": "http://loinc.org",
                  "code": "8648-8",
                  "display": "Hospital course note"
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              "status": "generated",
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                  "code": "11535-2",
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            "title": "Diagnosis at Discharge"
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          {
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__hdr\"><tr><td>Postoperative analgesia administration</td><td><span class=\"nb\">21-Aug-1987</span></td><td>-</td></tr></table></div>"
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              {
                "reference": "urn:uuid:2e760a7c-b8f6-4c90-b20d-569517332531"
              },
              {
                "reference": "urn:uuid:6cbfb330-e563-4f0a-93e7-a2cdbbd165ff"
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              {
                "reference": "urn:uuid:4ac311b0-968c-43c2-9bd9-00087713da30"
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              ]
            },
            "title": "Significant procedures"
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        ],
        "title": "Hospital Discharge Report",
        "status": "final",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
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        "custodian": {
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        "date": "1987-08-23T00:00:00Z",
        "confidentiality": "N"
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        "resourceType": "Patient",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
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              "system": "https://synderai.net/fhir/CodeSystem/tags",
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        "identifier": [
          {
            "type": {
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                {
                  "code": "JHN",
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            "system": "http://ec.europa.eu/identifier/eci",
            "value": "1886-624637-6"
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          {
            "type": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
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            "system": "http://local.setting.eu/identifier",
            "value": "906499d7-f832-0f36-ee43-9b0362d80881"
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        ],
        "name": [
          {
            "given": [
              "Mathilde"
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            "family": "Kraushaar",
            "text": "Mathilde Kraushaar"
          }
        ],
        "address": [
          {
            "line": [
              "Bolanderweg 4-5"
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            "use": "home",
            "type": "physical",
            "postalCode": "85049",
            "city": "Ingolstadt",
            "country": "Germany"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "0478214724"
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        ],
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            "extension": [
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                "url": "code",
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                  "coding": [
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                      "code": "DE",
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                  ]
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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>Mathilde Kraushaar</td><td>female</td><td>31-Dec-1984</td></tr></table></div>"
        },
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        "birthDate": "1984-12-31"
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          {
            "type": [
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                "coding": [
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                    "code": "PPRF",
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                    "display": "primary performer"
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                ]
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            ],
            "period": {
              "end": "1987-08-23"
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                "code": "74400008",
                "system": "http://snomed.info/sct",
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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>Heilpädagogisches Zentrum, Ingolstadt, Germany</td><td>20-08-1987 - 23-08-1987</td><td><ul><li>Appendicitis (disorder)</li></ul></td></tr></table></div>"
        },
        "status": "completed",
        "class": {
          "code": "IMP",
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode"
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        "serviceProvider": {
          "reference": "urn:uuid:2316143f-b754-4326-a5ab-b95b3eea68de"
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        "subject": {
          "reference": "Patient/28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
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    {
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        "resourceType": "PractitionerRole",
        "id": "429a1127-77e1-48af-bb6e-d7614c94b1b5",
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          "profile": [
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital Role Id: 429a1127-77e1-48af-bb6e-d7614c94b1b5</div>"
        },
        "practitioner": {
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        "organization": {
          "reference": "urn:uuid:2316143f-b754-4326-a5ab-b95b3eea68de"
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        "address": [
          {
            "city": "Ingolstadt",
            "postalCode": "85049",
            "country": "Germany"
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital: Heilpädagogisches Zentrum, 85049 Ingolstadt, Germany</div>"
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        "name": "Heilpädagogisches Zentrum"
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    {
      "fullUrl": "urn:uuid:5346e7c3-b295-4361-bd1f-7c669712b2e2",
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        "resourceType": "Practitioner",
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        "identifier": [
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            "value": "3187e563-b027-49b9-bbc1-3227ef04de76"
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        "name": [
          {
            "prefix": [
              "Dr."
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            "given": [
              "Rudolf"
            ],
            "family": "Dörschner"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Practitioner in Hospital: Dr. Rudolf Dörschner</div>"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:ca7e65d4-6238-410c-9613-87756ebc8b33",
      "resource": {
        "resourceType": "Condition",
        "id": "ca7e65d4-6238-410c-9613-87756ebc8b33",
        "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": "K37",
              "system": "http://hl7.org/fhir/sid/icd-10",
              "display": "Unspecified appendicitis"
            }
          ],
          "text": "Unspecified appendicitis"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Unspecified appendicitis</td><td><span class=\"nb\">23-Aug-1987</span></td><td>active</td></tr></table></div>"
        },
        "onsetDateTime": "1987-08-23",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:ed925378-7b6b-4b36-92e6-91ae6c84f194",
      "resource": {
        "resourceType": "Procedure",
        "id": "ed925378-7b6b-4b36-92e6-91ae6c84f194",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "5880005",
              "system": "http://snomed.info/sct",
              "display": "Physical examination procedure (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Physical examination including assessment of McBurney's point</td><td><span class=\"nb\">20-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-20",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:c0d8d3d7-1bec-4615-8f53-7307dbd9104c",
      "resource": {
        "resourceType": "Procedure",
        "id": "c0d8d3d7-1bec-4615-8f53-7307dbd9104c",
        "meta": {
          "profile": [
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        },
        "code": {
          "coding": [
            {
              "code": "26604007",
              "system": "http://snomed.info/sct",
              "display": "Complete blood count (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Blood test - full blood count confirming leukocytosis</td><td><span class=\"nb\">20-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-20",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:d026d69d-754d-420c-a0dd-659e90b2f89c",
      "resource": {
        "resourceType": "Procedure",
        "id": "d026d69d-754d-420c-a0dd-659e90b2f89c",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
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        },
        "code": {
          "coding": [
            {
              "code": "45036003",
              "system": "http://snomed.info/sct",
              "display": "Ultrasonography of abdomen (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Abdominal ultrasound to assess appendix</td><td><span class=\"nb\">20-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-20",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:b4e431dd-06f2-4ec0-9eb2-72bba50a0478",
      "resource": {
        "resourceType": "Procedure",
        "id": "b4e431dd-06f2-4ec0-9eb2-72bba50a0478",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "56342008",
              "system": "http://snomed.info/sct",
              "display": "Temperature taking (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Body temperature measurement - low-grade fever noted</td><td><span class=\"nb\">20-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-20",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:7847c671-5ab6-4b7b-be34-3313666100f0",
      "resource": {
        "resourceType": "Procedure",
        "id": "7847c671-5ab6-4b7b-be34-3313666100f0",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "782902008",
              "system": "http://snomed.info/sct",
              "display": "Implantation procedure (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Histopathological examination of appendix specimen</td><td><span class=\"nb\">21-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-21",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:2e760a7c-b8f6-4c90-b20d-569517332531",
      "resource": {
        "resourceType": "Procedure",
        "id": "2e760a7c-b8f6-4c90-b20d-569517332531",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "18629005",
              "system": "http://snomed.info/sct",
              "display": "Administration of drug or medicament (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Administration of perioperative antibiotic prophylaxis</td><td><span class=\"nb\">20-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1987-08-20",
        "subject": {
          "reference": "urn:uuid:28f904d2-2041-484c-b306-fa68cc112e8b",
          "display": "Mathilde Kraushaar"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:6cbfb330-e563-4f0a-93e7-a2cdbbd165ff",
      "resource": {
        "resourceType": "Procedure",
        "id": "6cbfb330-e563-4f0a-93e7-a2cdbbd165ff",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
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        },
        "code": {
          "coding": [
            {
              "code": "80146002",
              "system": "http://snomed.info/sct",
              "display": "Excision of appendix (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Open appendectomy performed under general anaesthesia</td><td><span class=\"nb\">21-Aug-1987</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
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        "version": [
          {
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">SYNDERAI Synthetic Generator v5.0</div>"
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        "status": "active",
        "distinctIdentifier": "synderai-generator-50",
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          "text": "Synthetic Example Data Generation"
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            ],
            "text": "Interoperability Testing and Training (non-clinical use)"
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        "text": {
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provenance for SYNDERAI Synthetic Example Data Resource</div>"
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        "recorded": "2026-03-20T18:20:35Z"
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  "timestamp": "1987-08-23T00:00:00Z"
}