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                  {
                    "reference": "urn:uuid:1efe2df0-61c0-4420-b5b7-5c58786ecebd"
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                    "reference": "urn:uuid:4355b79a-4c62-465b-9f51-484ab25da132"
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                  {
                    "reference": "urn:uuid:06b77996-ba67-4852-8e88-42b490bb1b38"
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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>04-JUL-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>98.8</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>15.9</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>9.4</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>142.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>103.5</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>26.5</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>3.0 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>98.8</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>15.9</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td>0.9</td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.4</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>142.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>103.5</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>26.5</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
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                      "display": "Urinalysis studies (set)"
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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>04-JUL-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>0.5</td><td>0 - 5</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>1.0</td><td>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>19.6 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>6.8</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>247.4 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>"
                },
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              {
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                  "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>04-JUL-2018</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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              "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 significant proteinuria, ketonuria, low specific gravity, and abnormal urine color/appearance, indicating possible renal pathology (e.g., nephrotic syndrome or acute kidney injury). HbA1c is low, but current glucose is normal. No evidence of urinary tract infection. Recommend further nephrological evaluation and monitoring of renal function and proteinuria.</td></tr></table></div>"
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          "display": "Patricia Joubert"
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        "date": "2018-07-04T08:42:07Z",
        "title": "Laboratory Report",
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            ],
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        ],
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        "gender": "female",
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          {
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              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "unit": "mmol/L",
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              "code": "2823-3",
              "system": "http://loinc.org",
              "display": "Potassium [Moles/volume] in Serum or Plasma"
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          "text": "Potassium [Moles/volume] in Serum or Plasma"
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              "value": 0,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 4,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "interpretation": [
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            "coding": [
              {
                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Mass/volume] in Urine by Test strip</td><td>19.6</td><td>0 - 4</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Patricia Joubert"
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        "specimen": {
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      }
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                "code": "laboratory",
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            ]
          }
        ],
        "performer": [
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            "display": "The Central European Lab"
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        ],
        "code": {
          "coding": [
            {
              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
            }
          ],
          "text": "Ketones [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>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = +</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:cb6dcf1e-2436-4541-9d2f-b6edbafab9d3",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "code": "167289004",
              "system": "http://snomed.info/sct",
              "display": "Urine ketone test = +"
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          ]
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      }
    },
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      "fullUrl": "urn:uuid:512c602a-aa78-4777-affc-ff02b1fe5f58",
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        "category": [
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            ]
          }
        ],
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          {
            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "5811-5",
              "system": "http://loinc.org",
              "display": "Specific gravity of Urine by Test strip"
            }
          ],
          "text": "Specific gravity of Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 1,
          "unit": "{nominal}",
          "code": "1"
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        "referenceRange": [
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            "low": {
              "value": 1.005,
              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
            },
            "high": {
              "value": 1.03,
              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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          }
        ],
        "interpretation": [
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            "coding": [
              {
                "code": "L",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Specific gravity of Urine by Test strip</td><td>1.0</td><td>1.005 - 1.030</td><td>L</td><td>{nominal}</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Patricia Joubert"
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        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:45ea293a-c814-4c68-9866-41c6508099a9",
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        "resourceType": "Observation",
        "id": "45ea293a-c814-4c68-9866-41c6508099a9",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
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        },
        "category": [
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                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
              }
            ]
          }
        ],
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            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "5803-2",
              "system": "http://loinc.org",
              "display": "pH of Urine by Test strip"
            }
          ],
          "text": "pH of Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 6.8,
          "unit": "pH",
          "code": "pH"
        },
        "referenceRange": [
          {
            "low": {
              "value": 5,
              "code": "pH",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 8,
              "code": "pH",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>6.8</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:cb6dcf1e-2436-4541-9d2f-b6edbafab9d3",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:7e91489f-c647-4da0-b551-6a994f06b4b7"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:9341591d-586f-4dd3-ad27-353bbedb8fe0",
      "resource": {
        "resourceType": "Observation",
        "id": "9341591d-586f-4dd3-ad27-353bbedb8fe0",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
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        },
        "category": [
          {
            "coding": [
              {
                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
              }
            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "5804-0",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Urine by Test strip"
            }
          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 247.4,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
          {
            "low": {
              "value": 0,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "interpretation": [
          {
            "coding": [
              {
                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>247.4</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:cb6dcf1e-2436-4541-9d2f-b6edbafab9d3",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:7e91489f-c647-4da0-b551-6a994f06b4b7"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:62af9b12-ff2b-450b-a4e1-44f2075c1723",
      "resource": {
        "resourceType": "Observation",
        "id": "62af9b12-ff2b-450b-a4e1-44f2075c1723",
        "meta": {
          "profile": [
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        },
        "category": [
          {
            "coding": [
              {
                "code": "laboratory",
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              }
            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
            }
          ],
          "text": "Protein [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>04-Jul-2018</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",
        "subject": {
          "reference": "urn:uuid:cb6dcf1e-2436-4541-9d2f-b6edbafab9d3",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "167276005",
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              "display": "Urine protein test = ++"
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    },
    {
      "fullUrl": "urn:uuid:71e51ff6-076b-4704-9f81-06a5cbc0b70a",
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        "id": "71e51ff6-076b-4704-9f81-06a5cbc0b70a",
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        },
        "category": [
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            "coding": [
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                "code": "laboratory",
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            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
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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>04-Jul-2018</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",
        "subject": {
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          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "314138001",
              "system": "http://snomed.info/sct",
              "display": "Urine nitrite negative"
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        },
        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:397ad255-3e4d-4396-baf3-e8fe48ea9aee",
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        },
        "category": [
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            "coding": [
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                "code": "laboratory",
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            ]
          }
        ],
        "performer": [
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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>04-Jul-2018</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",
        "subject": {
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          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "167297006",
              "system": "http://snomed.info/sct",
              "display": "Urine blood test = negative"
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          ]
        },
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      }
    },
    {
      "fullUrl": "urn:uuid:0039e34b-b52e-43cd-b6e0-47350af93750",
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        "category": [
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                "code": "laboratory",
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              }
            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
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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>04-Jul-2018</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": {
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          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "code": "394717006",
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              "display": "Urine leukocyte test negative"
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        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:65ea3484-15da-4c5b-9c47-65fd726c7830",
      "resource": {
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        "meta": {
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        },
        "category": [
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            ]
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        ],
        "performer": [
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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,
          "unit": "%",
          "code": "%"
        },
        "referenceRange": [
          {
            "low": {
              "value": 4,
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 5.6,
              "code": "%",
              "system": "http://unitsofmeasure.org"
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        "interpretation": [
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            "coding": [
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                "code": "L",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
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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>04-Jul-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>3.0</td><td>4.0 - 5.6</td><td>L</td><td>%</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:cb6dcf1e-2436-4541-9d2f-b6edbafab9d3",
          "display": "Patricia Joubert"
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        "effectiveDateTime": "2018-07-04T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:f6525415-85cf-4cc0-bb28-0b79291fe53a"
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      }
    },
    {
      "fullUrl": "urn:uuid:c2578b36-e8ad-4ec4-b2f4-6fd41e9dcc3c",
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        "resourceType": "Observation",
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        },
        "category": [
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            "coding": [
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                "code": "laboratory",
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              }
            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "2339-0",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Blood"
            }
          ],
          "text": "Glucose [Mass/volume] in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 98.8,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
          {
            "low": {
              "value": 70,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 140,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
          "status": "generated",
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            "postalCode": "1000",
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  "timestamp": "2018-07-04T08:42:07Z"
}