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                    "reference": "urn:uuid:b777f2b6-77de-4181-9dbc-b26cae6c7e1d"
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                  {
                    "reference": "urn:uuid:60953a7f-8d97-4abf-9e1d-70ec361b9a79"
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                    "reference": "urn:uuid:4f87ee63-8b5a-4069-9d10-632b8d6b47ca"
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                  "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-JUL-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>99.3</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>13.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.1 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>8.8</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>139.8</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.7</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>104.4</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td><strong>21.0 L</strong></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>99.3</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>13.4</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>8.8</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>139.8</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.7</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>104.4</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td><strong>21.0 L</strong></td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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                  "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-JUL-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>1.4</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>0.6</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>4.7 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>5.9</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>284.7 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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                  "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-JUL-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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              "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, low total CO₂, and significant proteinuria, suggesting possible renal impairment with metabolic acidosis. Urinalysis reveals protein, glucose, ketones, low specific gravity, and abnormal appearance, raising concern for nephrotic syndrome or diabetic nephropathy, though HbA1c is low. No evidence of urinary infection. Recommend further renal evaluation and clinical correlation for underlying etiology.</td></tr></table></div>"
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        "date": "2019-07-31T08:42:07Z",
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              "display": "Potassium [Moles/volume] in Serum or Plasma"
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          "text": "Potassium [Moles/volume] in Serum or Plasma"
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            },
            "high": {
              "value": 4,
              "code": "mg/dL",
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            ]
          }
        ],
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        },
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        "code": {
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            {
              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
            }
          ],
          "text": "Ketones [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-Jul-2019</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>"
        },
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              "display": "Urine ketone test = +"
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          "coding": [
            {
              "code": "5811-5",
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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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        "valueQuantity": {
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          "value": 1,
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              "unit": "Specific Gravity"
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              "value": 1.03,
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              "unit": "Specific Gravity"
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            ]
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        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>31-Jul-2019</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>"
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      "fullUrl": "urn:uuid:751d9217-c298-44b0-9d11-da2ef250a039",
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        "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": 5.9,
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            },
            "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>31-Jul-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>5.9</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:0abf37fe-ab8b-4165-9bee-a6147210f8a6",
          "display": "Patricia Joubert"
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        "effectiveDateTime": "2019-07-31T06:42:07Z",
        "specimen": {
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        }
      }
    },
    {
      "fullUrl": "urn:uuid:1468e6aa-3417-4d85-b9ac-4e065024c23e",
      "resource": {
        "resourceType": "Observation",
        "id": "1468e6aa-3417-4d85-b9ac-4e065024c23e",
        "meta": {
          "profile": [
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        },
        "category": [
          {
            "coding": [
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                "code": "laboratory",
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            ]
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        ],
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        ],
        "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": 284.7,
          "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"
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          }
        ],
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            "coding": [
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                "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>31-Jul-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>284.7</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "specimen": {
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      }
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    {
      "fullUrl": "urn:uuid:38c1b7cb-ad5b-4ea5-9139-af19bc8eab67",
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        "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>31-Jul-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": "2019-07-31T06:42:07Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = ++"
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        "code": {
          "coding": [
            {
              "code": "5802-4",
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              "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-Jul-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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          "display": "Patricia Joubert"
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        "effectiveDateTime": "2019-07-31T06:42:07Z",
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              "display": "Urine nitrite negative"
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        "code": {
          "coding": [
            {
              "code": "5794-3",
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              "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-Jul-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>"
        },
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              "display": "Urine blood test = negative"
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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-Jul-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>"
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          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
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        "valueQuantity": {
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          "value": 3,
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        ],
        "text": {
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        },
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    },
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        ],
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        ],
        "code": {
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            {
              "code": "2339-0",
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              "display": "Glucose [Mass/volume] in Blood"
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          ],
          "text": "Glucose [Mass/volume] in Blood"
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        "valueQuantity": {
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          "value": 99.3,
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        },
        "referenceRange": [
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            },
            "high": {
              "value": 140,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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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-Jul-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>99.3</td><td>70 - 140</td><td></td><td>mg/dL</td></tr></table></div>"
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            "postalCode": "1000",
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}