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                  {
                    "reference": "urn:uuid:1aa385d8-fa57-4ddd-925c-873daaa14016"
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                  {
                    "reference": "urn:uuid:41c5e41c-2876-4f51-876b-7832e15d3021"
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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>18-MAY-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>87.1</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>11.1</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><strong>8.5 L</strong></td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>3.9</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>110.6 H</strong></td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>25.7</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>3.4 L</strong></td><td>4.8 - 5.9</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>87.1</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>11.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>2.5 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>8.5</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>3.9</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td><strong>110.6 H</strong></td><td>98 - 110</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>25.7</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
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                  "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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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>18-MAY-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>0.8</td><td>0 - 20</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>0.3</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>12.6 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>6.2</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>198.7 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>"
                },
                "title": "Urinalysis"
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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>18-MAY-2025</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 creatinine, proteinuria, and low urine specific gravity, suggesting impaired renal function. Urine is cloudy, brown, and ammoniacal, but without evidence of infection (negative nitrite/leukocytes). There is also hypocalcemia, hyperchloremia, and elevated urinary ketones. HbA1c is unexpectedly low. Findings are consistent with chronic kidney disease, possibly with acute component; further nephrological evaluation is recommended.</td></tr></table></div>"
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        "date": "2025-05-18T01:37:39Z",
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        "address": [
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            "use": "home",
            "type": "physical",
            "postalCode": "96317",
            "city": "Kronach",
            "country": "Germany"
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        ],
        "telecom": [
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            "value": "06478333493"
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        ],
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
        "text": {
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        "gender": "male",
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    {
      "fullUrl": "urn:uuid:b13e8d27-d7cb-47b0-9394-6d2dec4e3e2a",
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        "resourceType": "ServiceRequest",
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          {
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          {
            "reference": "urn:uuid:c7589ae0-3f0d-4def-a4c1-b31d8d1be9bb"
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        ],
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          {
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              {
                "code": "127013003",
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                "display": "Disorder of kidney due to diabetes mellitus"
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            ]
          },
          {
            "coding": [
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                "code": "431856006",
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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": "55822004",
                "system": "http://snomed.info/sct",
                "display": "Hyperlipidemia"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Chronic sinusitis"
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          {
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                "code": "414545008",
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          {
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          {
            "coding": [
              {
                "code": "271737000",
                "system": "http://snomed.info/sct",
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            ]
          }
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "active",
        "intent": "order",
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              "display": "Laboratory procedure"
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        "text": {
          "status": "generated",
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        "organization": {
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              "display": "HL7 Europe"
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          {
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            "city": "Kronach",
            "postalCode": "96317",
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        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Medizinisches Versorgungszentrum Kronach</div>"
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        "name": "Medizinisches Versorgungszentrum Kronach"
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    {
      "fullUrl": "urn:uuid:e37e3635-bee7-4a19-9d7e-7ef017e065ee",
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          ]
        },
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          "status": "generated",
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        "type": {
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            {
              "code": "122592007",
              "system": "http://snomed.info/sct",
              "display": "Acellular blood (serum or plasma) specimen"
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        },
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            {
              "code": "122575003",
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            {
              "code": "258580003",
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              "display": "Whole blood specimen (specimen)"
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    {
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              "code": "2345-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Serum or Plasma"
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          "text": "Glucose [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 87.1,
          "unit": "mg/dL",
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            "high": {
              "value": 100,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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          }
        ],
        "text": {
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        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2025-05-17T23:37:39Z",
        "specimen": {
          "reference": "urn:uuid:e37e3635-bee7-4a19-9d7e-7ef017e065ee"
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    {
      "fullUrl": "urn:uuid:4aa19e7d-7687-4bcd-9ca3-5a73cfabe061",
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        "code": {
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            {
              "code": "3094-0",
              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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          "unit": "mg/dL",
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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    {
      "fullUrl": "urn:uuid:8f5951bd-d874-4b4a-bbae-c7100e11e11e",
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        "code": {
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              "system": "http://loinc.org",
              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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              "code": "mg/dL",
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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        ],
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        "status": "final",
        "subject": {
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              "system": "http://loinc.org",
              "display": "Calcium [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Calcium [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 8.5,
          "unit": "mg/dL",
          "code": "mg/dL"
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
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            ]
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        ],
        "text": {
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        "specimen": {
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              "code": "2951-2",
              "system": "http://loinc.org",
              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "text": "Sodium [Moles/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 138.9,
          "unit": "mmol/L",
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              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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          }
        ],
        "text": {
          "status": "generated",
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        "status": "final",
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    {
      "fullUrl": "urn:uuid:213d9ca3-6bd6-4f81-9ee3-29acf2a0adb3",
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        "category": [
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        "performer": [
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        "code": {
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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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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 3.9,
          "unit": "mmol/L",
          "code": "mmol/L"
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            "high": {
              "value": 5.1,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
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        "status": "final",
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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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              "code": "5803-2",
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        },
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        "specimen": {
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    {
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      "resource": {
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        "code": {
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            {
              "code": "5804-0",
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              "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": {
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          "value": 198.7,
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        "text": {
          "status": "generated",
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        "status": "final",
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              "code": "20454-5",
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
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        },
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        "code": {
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              "code": "5802-4",
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              "display": "Nitrite [Presence] in Urine by Test strip"
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          ],
          "text": "Nitrite [Presence] in Urine by Test strip"
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        },
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              "code": "5794-3",
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              "display": "Hemoglobin [Presence] in Urine by Test strip"
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          ],
          "text": "Hemoglobin [Presence] in Urine by Test strip"
        },
        "text": {
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        },
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            {
              "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>18-May-2025</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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        "code": {
          "coding": [
            {
              "code": "4548-4",
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              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
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        "valueQuantity": {
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          "value": 3.4,
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        ],
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              "code": "2339-0",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Blood"
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          ],
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          }
        ],
        "text": {
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        },
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}