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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Acute appendicitis, appendectomy performed</div>"
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          {
            "text": {
              "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 male, admitted on 27th February 1995 with acute right iliac fossa pain, nausea, and low-grade fever. Clinical examination revealed rebound tenderness at McBurney's point. Laboratory investigations confirmed elevated white cell count and CRP consistent with acute appendicitis. Abdominal ultrasound supported the diagnosis. The patient underwent an uncomplicated open appendectomy on 27th February 1995 under general anaesthesia. Histopathological examination confirmed acute appendicitis. Postoperative recovery was uneventful. Analgesia and intravenous antibiotics were administered perioperatively. The patient was discharged home on 28th February 1995 in good condition. Please arrange wound review in approximately one week and ensure appropriate analgesia is prescribed. Should any concerns arise, please do not hesitate to contact our surgical department.</div>"
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            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__hdr\"><tr><td>Unspecified appendicitis</td><td><span class=\"nb\">28-Feb-1995</span></td><td>active</td></tr></table></div>"
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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>Wound care and dressing</td><td><span class=\"nb\">28-Feb-1995</span></td><td>-</td></tr></table></div>"
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                "reference": "urn:uuid:fdbd1977-a049-4c8a-a16b-bc82fcf8568f"
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            },
            "title": "Significant procedures"
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        ],
        "title": "Hospital Discharge Report",
        "status": "final",
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          "display": "David Lacombe"
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        "date": "1995-02-28T00:00:00Z",
        "confidentiality": "N"
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
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          ],
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        "identifier": [
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            "type": {
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                  "code": "JHN",
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              ]
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            "system": "http://ec.europa.eu/identifier/eci",
            "value": "4948-900427-2"
          },
          {
            "type": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
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            "system": "http://local.setting.eu/identifier",
            "value": "4181d993-2aca-7d1b-aae7-eae8eb38b428"
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        "name": [
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            "given": [
              "David"
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            "text": "David Lacombe"
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        ],
        "address": [
          {
            "line": [
              "168, rue Diane François"
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            "use": "home",
            "type": "physical",
            "postalCode": "77320",
            "city": "Saint Michelle-la-Forêt",
            "country": "France"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "04 66 16 64 94"
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        ],
        "extension": [
          {
            "extension": [
              {
                "url": "code",
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                  "coding": [
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                      "code": "FR",
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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>David Lacombe</td><td>male</td><td>14-Jun-1985</td></tr></table></div>"
        },
        "gender": "male",
        "birthDate": "1985-06-14"
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          ]
        },
        "participant": [
          {
            "type": [
              {
                "coding": [
                  {
                    "code": "PPRF",
                    "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                    "display": "primary performer"
                  }
                ]
              }
            ],
            "period": {
              "end": "1995-02-28"
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            "individual": {
              "reference": "urn:uuid:d0bcc2e1-88e5-4c62-9192-3e9e49030ec4"
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                "code": "74400008",
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                "display": "Appendicitis (disorder)"
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            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Hôtel-Dieu, Paris, France</td><td>27-02-1995 - 28-02-1995</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"
        },
        "serviceProvider": {
          "reference": "urn:uuid:31cd39b4-309c-4891-90b1-10bed4889127"
        },
        "subject": {
          "reference": "Patient/e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
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      "resource": {
        "resourceType": "PractitionerRole",
        "id": "64da76c9-df05-40c8-8322-5772a5b8542e",
        "meta": {
          "profile": [
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        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital Role Id: 64da76c9-df05-40c8-8322-5772a5b8542e</div>"
        },
        "practitioner": {
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        "organization": {
          "reference": "urn:uuid:31cd39b4-309c-4891-90b1-10bed4889127"
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    {
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      "resource": {
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        "address": [
          {
            "city": "Paris",
            "postalCode": "75001",
            "country": "France"
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Hospital: Hôtel-Dieu, 75001 Paris, France</div>"
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        "name": "Hôtel-Dieu"
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    {
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      "resource": {
        "resourceType": "Practitioner",
        "id": "d0bcc2e1-88e5-4c62-9192-3e9e49030ec4",
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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": "e3951914-3559-45fe-b6a4-34b1d6dc53f0"
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        ],
        "name": [
          {
            "prefix": [
              "dr"
            ],
            "given": [
              "Tristan"
            ],
            "family": "Gilbert"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Practitioner in Hospital: dr Tristan Gilbert</div>"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:f73a920e-768b-4fd1-8d9d-9fd395c0bc39",
      "resource": {
        "resourceType": "Condition",
        "id": "f73a920e-768b-4fd1-8d9d-9fd395c0bc39",
        "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\">28-Feb-1995</span></td><td>active</td></tr></table></div>"
        },
        "onsetDateTime": "1995-02-28",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:ca433c1d-d2ac-4b51-961b-6686f9270c2a",
      "resource": {
        "resourceType": "Procedure",
        "id": "ca433c1d-d2ac-4b51-961b-6686f9270c2a",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
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        },
        "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\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:c8371d73-3465-4b56-8a6a-d54cc896d13c",
      "resource": {
        "resourceType": "Procedure",
        "id": "c8371d73-3465-4b56-8a6a-d54cc896d13c",
        "meta": {
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        "code": {
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              "code": "767002",
              "system": "http://snomed.info/sct",
              "display": "White blood cell count (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>White blood cell count measurement</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
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      }
    },
    {
      "fullUrl": "urn:uuid:12ae662e-9785-403b-81e5-a2be2979a04d",
      "resource": {
        "resourceType": "Procedure",
        "id": "12ae662e-9785-403b-81e5-a2be2979a04d",
        "meta": {
          "profile": [
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        },
        "code": {
          "coding": [
            {
              "code": "55235003",
              "system": "http://snomed.info/sct",
              "display": "C-reactive protein measurement (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>C-reactive protein measurement</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:f4aa95f4-5279-40f0-86f5-3af4f47df1f3",
      "resource": {
        "resourceType": "Procedure",
        "id": "f4aa95f4-5279-40f0-86f5-3af4f47df1f3",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "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</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:37020bc8-f023-4884-aa24-cc1612b90795",
      "resource": {
        "resourceType": "Procedure",
        "id": "37020bc8-f023-4884-aa24-cc1612b90795",
        "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</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:5428b370-f7a9-48e0-96c3-3aad458d0122",
      "resource": {
        "resourceType": "Procedure",
        "id": "5428b370-f7a9-48e0-96c3-3aad458d0122",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "50697003",
              "system": "http://snomed.info/sct",
              "display": "Administration of general anesthetic (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>General anaesthesia</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:fdbd1977-a049-4c8a-a16b-bc82fcf8568f",
      "resource": {
        "resourceType": "Procedure",
        "id": "fdbd1977-a049-4c8a-a16b-bc82fcf8568f",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "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</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:a2a2f729-98fd-4502-a05b-d38b38514afa",
      "resource": {
        "resourceType": "Procedure",
        "id": "a2a2f729-98fd-4502-a05b-d38b38514afa",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
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        },
        "code": {
          "coding": [
            {
              "code": "229070002",
              "system": "http://snomed.info/sct",
              "display": "Stretching exercises (regime/therapy)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Postoperative analgesia administration</td><td><span class=\"nb\">27-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-27",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:a0e5ef22-a523-45c5-9e82-061465150570",
      "resource": {
        "resourceType": "Procedure",
        "id": "a0e5ef22-a523-45c5-9e82-061465150570",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/procedure-eu-core"
          ]
        },
        "code": {
          "coding": [
            {
              "code": "182531007",
              "system": "http://snomed.info/sct",
              "display": "Dressing of wound (procedure)"
            }
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Wound care and dressing</td><td><span class=\"nb\">28-Feb-1995</span></td><td>-</td></tr></table></div>"
        },
        "status": "completed",
        "performedDateTime": "1995-02-28",
        "subject": {
          "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab",
          "display": "David Lacombe"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:9b41407b-e759-4398-b845-b267175212cd",
      "resource": {
        "resourceType": "Device",
        "id": "9b41407b-e759-4398-b845-b267175212cd",
        "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:91069d2e-dcbb-4dde-a763-b84c3da92de1",
      "resource": {
        "resourceType": "Provenance",
        "id": "91069d2e-dcbb-4dde-a763-b84c3da92de1",
        "target": [
          {
            "reference": "urn:uuid:e39827e8-5d8e-44ed-bd71-37f0e59898ab"
          },
          {
            "reference": "urn:uuid:64da76c9-df05-40c8-8322-5772a5b8542e"
          },
          {
            "reference": "urn:uuid:d0bcc2e1-88e5-4c62-9192-3e9e49030ec4"
          },
          {
            "reference": "urn:uuid:31cd39b4-309c-4891-90b1-10bed4889127"
          }
        ],
        "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"
            },
            "who": {
              "reference": "urn:uuid:9b41407b-e759-4398-b845-b267175212cd"
            }
          }
        ],
        "reason": [
          {
            "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": "2026-03-20T18:15:21Z"
      }
    }
  ],
  "type": "document",
  "timestamp": "1995-02-28T00:00:00Z"
}