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              "display": "Laboratory report"
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            "code": {
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                  "code": "26436-6",
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                  "display": "Laboratory studies (set)"
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            "section": [
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                "code": {
                  "coding": [
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                      "code": "18719-5",
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                      "display": "Chemistry studies (set)"
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                  "text": "Chemistry"
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                "entry": [
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                    "reference": "urn:uuid:175af01f-8f3e-4b9f-be25-954f44e02713"
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                  {
                    "reference": "urn:uuid:30766456-2c5c-4743-bf27-6cf132dbc9cb"
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                    "reference": "urn:uuid:46d51e71-2c88-4bc0-87a4-9199b0b79b42"
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                  {
                    "reference": "urn:uuid:cbb9aaf1-fb9d-496d-b93b-57474ac7fc30"
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                    "reference": "urn:uuid:80b0a2e9-ac2b-44ee-b166-cd57928f587b"
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                    "reference": "urn:uuid:734760bd-fcb5-4c6e-845d-b65614a02316"
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                  {
                    "reference": "urn:uuid:5ffccb7d-52da-43ef-987e-66e9b4561350"
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                  {
                    "reference": "urn:uuid:ecf8eacb-746f-4265-a336-044c80a69186"
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                    "reference": "urn:uuid:333d7195-9a1d-4056-a4b1-936ab044ebb4"
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                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>31-MAR-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>89.4</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>8.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.0 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>8.5</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>143.4</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.1</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>107.0</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>26.6</td><td>22 - 29</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = +</td><td></td><td></td></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td><strong>3.3 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
                  "coding": [
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                      "code": "18729-4",
                      "system": "http://loinc.org",
                      "display": "Urinalysis studies (set)"
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                  "text": "Urinalysis"
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                "entry": [
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                    "reference": "urn:uuid:e0d9d9da-9104-4619-a46a-1d5fa98a629e"
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                    "reference": "urn:uuid:9379cd58-bb9f-4dbb-87ac-61f48a6029eb"
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                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>31-MAR-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td><strong>1.6 H</strong></td><td>0 - 0.8</td><td>mg/dL</td></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>Urine glucose test = ++</td><td></td><td></td></tr><tr><td>Bilirubin.total [Mass/volume] in Urine by Test strip</td><td><strong>1.1 H</strong></td><td>0.0 - 0.4</td><td>mg/dL</td></tr><tr><td>Bilirubin.total [Presence] in Urine by Test strip</td><td>Finding of bilirubin in urine</td><td></td><td></td></tr><tr><td>Ketones [Mass/volume] in Urine by Test strip</td><td><strong>15.4 H</strong></td><td>0 - 4</td><td>mg/dL</td></tr><tr><td>Specific gravity of Urine by Test strip</td><td><strong>1.0 L</strong></td><td>1.005 - 1.030</td><td>{nominal}</td></tr><tr><td>pH of Urine by Test strip</td><td>5.3</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>220.4 H</strong></td><td>0 - 20</td><td>mg/dL</td></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = ++</td><td></td><td></td></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td><td></td><td></td></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td><td></td><td></td></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td><td>Urine leukocyte test negative</td><td></td><td></td></tr></tbody></table></div>"
                },
                "title": "Urinalysis"
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              {
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                      "system": "http://loinc.org",
                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:539303c1-312e-483c-9282-925b88bd524b"
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                  {
                    "reference": "urn:uuid:1bbeb82b-9043-4bad-a308-b958776f8b62"
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                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Specimen information</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>31-MAR-2019</th><th>Specimen</th><th></th></tr></thead><tbody><tr><td>Appearance of Urine</td><td>Cloudy urine</td><td>Urine</td><td></td></tr><tr><td>Odor of Urine</td><td>Urine smell ammoniacal</td><td>Urine</td><td></td></tr><tr><td>Clarity of Urine</td><td>Translucent</td><td>Urine</td><td></td></tr><tr><td>Color of Urine</td><td>Brown color</td><td>Urine</td><td></td></tr></tbody></table></div>"
                },
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            ],
            "title": "Laboratory Report"
          },
          {
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Annotation</h3><table class=\"hl7__eu__lab__report\"><tr><th>Conclusion and Recommendations based on this report and previous findings known to us</th></tr><tr><td>The patient shows elevated serum creatinine, suggesting impaired renal function. Urinalysis reveals proteinuria, glucosuria, ketonuria, and bilirubinuria, with low specific gravity, indicating possible renal tubular dysfunction and/or uncontrolled diabetes, though HbA1c is low. Cloudy, brown, ammoniacal urine may suggest urinary tract pathology, but no evidence of infection (negative nitrite/leukocytes). Recommend further nephrological and metabolic evaluation.</td></tr></table></div>"
            },
            "code": {
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        "text": {
          "status": "empty",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:762185c2-851f-40b9-a488-cc73cc83bc2e",
          "display": "Yves Rémy"
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        "date": "2019-03-31T07:32:03Z",
        "title": "Laboratory Report",
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          "status": "empty",
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          "reference": "urn:uuid:762185c2-851f-40b9-a488-cc73cc83bc2e",
          "display": "Yves Rémy"
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              "code": "TRAIN"
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              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
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          ],
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        "identifier": [
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            "system": "http://ec.europa.eu/identifier/eci",
            "value": "4543-821530-8"
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            "value": "12ef67e4-2698-90f4-7860-a5366805885f"
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        ],
        "name": [
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            "given": [
              "Yves"
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            "family": "Rémy",
            "text": "Yves Rémy"
          }
        ],
        "address": [
          {
            "line": [
              "rue de Turpin"
            ],
            "use": "home",
            "type": "physical",
            "postalCode": "06400",
            "city": "Cannes",
            "country": "France"
          }
        ],
        "telecom": [
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            "system": "phone",
            "value": "+33 (0)1 53 38 28 55"
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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>Yves Rémy</td><td>male</td><td>16-May-1948</td></tr></table></div>"
        },
        "gender": "male",
        "birthDate": "1948-05-16"
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        ],
        "reasonCode": [
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                "code": "88805009",
                "system": "http://snomed.info/sct",
                "display": "Chronic congestive heart failure"
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            ]
          },
          {
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                "code": "431856006",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 2"
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            ]
          },
          {
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                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
          },
          {
            "coding": [
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                "code": "127013003",
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                "display": "Disorder of kidney due to diabetes mellitus"
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            ]
          },
          {
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                "display": "Chronic kidney disease stage 1"
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            ]
          },
          {
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                "code": "414545008",
                "system": "http://snomed.info/sct",
                "display": "Ischemic heart disease"
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            ]
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                "display": "Metabolic syndrome X"
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            ]
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          {
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              "code": "32167-9",
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          ],
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              "code": "5778-6",
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          ],
          "text": "Color of Urine"
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          ],
          "text": "Glucose [Mass/volume] in Urine by Test strip"
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              "code": "25428-4",
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              "display": "Glucose [Presence] in Urine by Test strip"
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        "code": {
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              "code": "20505-4",
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              "display": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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          "value": 1.1,
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        ],
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        },
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              "display": "Bilirubin.total [Presence] in Urine by Test strip"
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          "text": "Bilirubin.total [Presence] in Urine by Test strip"
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        "code": {
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              "code": "5797-6",
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              "display": "Ketones [Mass/volume] in Urine by Test strip"
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          "text": "Ketones [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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            "high": {
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        ],
        "text": {
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        "code": {
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              "code": "2514-8",
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              "display": "Ketones [Presence] in Urine by Test strip"
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          ],
          "text": "Ketones [Presence] in Urine by Test strip"
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        "text": {
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              "display": "Specific gravity of Urine by Test strip"
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          "text": "Specific gravity of Urine by Test strip"
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              "code": "5803-2",
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              "display": "pH of Urine by Test strip"
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          "text": "pH of Urine by Test strip"
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        "code": {
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              "code": "5804-0",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 220.4,
          "unit": "mg/dL",
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                "display": "High"
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>220.4</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
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        "code": {
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              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
        },
        "text": {
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = ++</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2019-03-31T05:32:03Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = ++"
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        ],
        "code": {
          "coding": [
            {
              "code": "5802-4",
              "system": "http://loinc.org",
              "display": "Nitrite [Presence] in Urine by Test strip"
            }
          ],
          "text": "Nitrite [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2019-03-31T05:32:03Z",
        "valueCodeableConcept": {
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              "display": "Urine nitrite negative"
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        ],
        "code": {
          "coding": [
            {
              "code": "5794-3",
              "system": "http://loinc.org",
              "display": "Hemoglobin [Presence] in Urine by Test strip"
            }
          ],
          "text": "Hemoglobin [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2019-03-31T05:32:03Z",
        "valueCodeableConcept": {
          "coding": [
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              "display": "Urine blood test = negative"
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    {
      "fullUrl": "urn:uuid:9379cd58-bb9f-4dbb-87ac-61f48a6029eb",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5799-2",
              "system": "http://loinc.org",
              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
            }
          ],
          "text": "Leukocyte esterase [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td><td>Urine leukocyte test negative</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:762185c2-851f-40b9-a488-cc73cc83bc2e",
          "display": "Yves Rémy"
        },
        "effectiveDateTime": "2019-03-31T05:32:03Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "code": "394717006",
              "system": "http://snomed.info/sct",
              "display": "Urine leukocyte test negative"
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      "fullUrl": "urn:uuid:333d7195-9a1d-4056-a4b1-936ab044ebb4",
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        "meta": {
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        "category": [
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            "display": "The Central European Lab"
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        ],
        "code": {
          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
            }
          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 3.3,
          "unit": "%",
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              "system": "http://unitsofmeasure.org"
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            "high": {
              "value": 5.6,
              "code": "%",
              "system": "http://unitsofmeasure.org"
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                "code": "L",
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                "display": "Low"
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            ]
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Mar-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>3.3</td><td>4.0 - 5.6</td><td>L</td><td>%</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Yves Rémy"
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        "effectiveDateTime": "2019-03-31T05:32:03Z",
        "specimen": {
          "reference": "urn:uuid:9904d06c-0aba-411d-912b-0fefbb0e80ff"
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    },
    {
      "fullUrl": "urn:uuid:3fe3ddd4-86ac-4c75-a440-f4b781104de6",
      "resource": {
        "resourceType": "Device",
        "id": "3fe3ddd4-86ac-4c75-a440-f4b781104de6",
        "deviceName": [
          {
            "name": "SYNDERAI Synthetic Generator",
            "type": "manufacturer-name"
          }
        ],
        "version": [
          {
            "value": "5.0"
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        ],
        "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:d2b216ac-8497-4785-afb3-4f9c4d2d16c7",
      "resource": {
        "resourceType": "Provenance",
        "id": "d2b216ac-8497-4785-afb3-4f9c4d2d16c7",
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          {
            "reference": "urn:uuid:33a2aa37-65f4-40d3-92aa-426dd888b847"
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          {
            "reference": "urn:uuid:74760f56-c31c-4da6-afe0-2fbeb83ba81c"
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          {
            "reference": "urn:uuid:f5202f6b-a710-40b9-b78a-0ae733dcfc85"
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            {
              "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"
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              ],
              "text": "author"
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            "who": {
              "reference": "urn:uuid:3fe3ddd4-86ac-4c75-a440-f4b781104de6"
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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": "2019-03-31T07:32:03Z"
      }
    },
    {
      "fullUrl": "urn:uuid:74760f56-c31c-4da6-afe0-2fbeb83ba81c",
      "resource": {
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        "id": "74760f56-c31c-4da6-afe0-2fbeb83ba81c",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: 74760f56-c31c-4da6-afe0-2fbeb83ba81c</div>"
        },
        "practitioner": {
          "reference": "urn:uuid:f5202f6b-a710-40b9-b78a-0ae733dcfc85"
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    {
      "fullUrl": "urn:uuid:f5202f6b-a710-40b9-b78a-0ae733dcfc85",
      "resource": {
        "resourceType": "Practitioner",
        "id": "f5202f6b-a710-40b9-b78a-0ae733dcfc85",
        "meta": {
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            "http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu"
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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": "5b5a2cef-e691-47fe-b5e7-eb0b4fa3f05e"
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        ],
        "name": [
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            "prefix": [
              "dr"
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            "given": [
              "Ex"
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            "family": "Ample"
          }
        ],
        "address": [
          {
            "line": [
              "Laboratoire Central Européenne",
              "Boulevard du Jardin Botanique 32"
            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
        }
      }
    }
  ],
  "type": "document",
  "timestamp": "2019-03-31T07:32:03Z"
}
