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                    "reference": "urn:uuid:0ea82ad9-05ba-4c29-8d4c-ff36b2257f8e"
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                    "reference": "urn:uuid:3955ef83-bcee-4d23-82ee-9aaf2f996a69"
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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>06-DEC-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td><strong>66.4 L</strong></td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.3</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>1.9 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>9.7</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>136.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.6</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>103.2</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>23.6</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>2.9 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td><strong>66.4 L</strong></td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>12.3</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>1.8 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.7</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>136.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.6</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>103.2</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>23.6</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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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>06-DEC-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>2.2</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>1.1</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>13.5 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>5.5</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>318.8 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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                  "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>06-DEC-2023</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 hypoglycemia and low HbA1c, with elevated creatinine suggesting impaired renal function. Urinalysis reveals significant proteinuria, ketonuria, glucosuria, and abnormal urine appearance (cloudy, brown, ammoniacal), but no evidence of infection. Findings are consistent with possible diabetic nephropathy and acute metabolic derangement. Clinical correlation and urgent evaluation are recommended.</td></tr></table></div>"
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
          }
        ],
        "text": {
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        "gender": "female",
        "birthDate": "1939-09-10"
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    {
      "fullUrl": "urn:uuid:3c81c460-d097-4ae3-ac3e-8639d95fad9c",
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        "resourceType": "ServiceRequest",
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        },
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          {
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          {
            "reference": "urn:uuid:d0e5c406-1b0c-4a69-9339-a63c11a411ac"
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        ],
        "reasonCode": [
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            "coding": [
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                "code": "433144002",
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                "display": "Chronic kidney disease stage 3"
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            ]
          },
          {
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              {
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                "system": "http://snomed.info/sct",
                "display": "Proteinuria due to type 2 diabetes mellitus"
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            ]
          },
          {
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              {
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            ]
          },
          {
            "coding": [
              {
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            ]
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          {
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            ]
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          {
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                "display": "Disorder of kidney due to diabetes mellitus"
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            ]
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          {
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                "display": "Ischemic heart disease"
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            ]
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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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                "display": "Mitral valve stenosis"
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            ]
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          {
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                "display": "Hyperlipidemia"
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                "display": "Metabolic syndrome X"
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              {
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                "system": "http://snomed.info/sct",
                "display": "Essential hypertension"
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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",
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              "display": "Laboratory procedure"
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          "reference": "urn:uuid:3aa394af-b538-418c-8e9c-ade136010229",
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        "identifier": [
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            "assigner": {
              "display": "HL7 Europe"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Maison Médical</div>"
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        "name": "Maison Médical"
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              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "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": {
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        ],
        "text": {
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        "code": {
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              "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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          "value": 136.5,
          "unit": "mmol/L",
          "code": "mmol/L"
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              "code": "mmol/L",
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        "text": {
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        "status": "final",
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        "specimen": {
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    {
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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": {
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          "value": 4.6,
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            "low": {
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            },
            "high": {
              "value": 4,
              "code": "mg/dL",
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        ],
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                "display": "High"
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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>06-Dec-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Mass/volume] in Urine by Test strip</td><td>13.5</td><td>0 - 4</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
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        ],
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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>06-Dec-2023</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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        "valueCodeableConcept": {
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            {
              "code": "167290008",
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              "display": "Urine ketone test = ++"
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        ],
        "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": {
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          "value": 1,
          "unit": "{nominal}",
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              "unit": "Specific Gravity"
            },
            "high": {
              "value": 1.03,
              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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          }
        ],
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                "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>06-Dec-2023</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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            ]
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        ],
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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": 5.5,
          "unit": "pH",
          "code": "pH"
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              "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>06-Dec-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>5.5</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:3aa394af-b538-418c-8e9c-ade136010229",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2023-12-06T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:a0a5303e-6342-49f8-87fa-e52d7594c706"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:0a51a4e2-d516-4bc4-b738-f656e2ff54af",
      "resource": {
        "resourceType": "Observation",
        "id": "0a51a4e2-d516-4bc4-b738-f656e2ff54af",
        "meta": {
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        },
        "category": [
          {
            "coding": [
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                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
              }
            ]
          }
        ],
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          {
            "display": "The Central European Lab"
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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": 318.8,
          "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": [
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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>06-Dec-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>318.8</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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      "fullUrl": "urn:uuid:37e513f5-3c78-4c18-9a93-010858cb1488",
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        "id": "37e513f5-3c78-4c18-9a93-010858cb1488",
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        ],
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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>06-Dec-2023</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": "2023-12-06T06:42:07Z",
        "valueCodeableConcept": {
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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>06-Dec-2023</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": "2023-12-06T06:42:07Z",
        "valueCodeableConcept": {
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              "display": "Urine nitrite negative"
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        ],
        "code": {
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            {
              "code": "5794-3",
              "system": "http://loinc.org",
              "display": "Hemoglobin [Presence] in Urine by Test strip"
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          ],
          "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>06-Dec-2023</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": "Patricia Joubert"
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        "effectiveDateTime": "2023-12-06T06:42:07Z",
        "valueCodeableConcept": {
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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>06-Dec-2023</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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          "display": "Patricia Joubert"
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        "valueCodeableConcept": {
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 2.9,
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              "value": 5.6,
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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>06-Dec-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>2.9</td><td>4.0 - 5.6</td><td>L</td><td>%</td></tr></table></div>"
        },
        "status": "final",
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        ],
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        ],
        "code": {
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              "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": 66.4,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
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            },
            "high": {
              "value": 140,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
              }
            ]
          }
        ],
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}