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                "code": {
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                      "display": "Chemistry studies (set)"
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                    "reference": "urn:uuid:ef4bc0bc-7a66-434f-a7fa-e26563401243"
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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>17-NOV-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>72.0</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>7.4</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 - 1.2</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>10.0</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>142.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.5</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>109.2 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><strong>20.3 L</strong></td><td>22 - 32</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = ++</td><td></td><td></td></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td><strong>3.3 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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              {
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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>17-NOV-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>1.0</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>0.4</td><td>0 - 1</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>8.5</td><td>0 - 20</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>6.9</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>295.6 H</strong></td><td>0 - 20</td><td>mg/dL</td></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = ++</td><td></td><td></td></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td><td></td><td></td></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td><td></td><td></td></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td><td>Urine leukocyte test negative</td><td></td><td></td></tr></tbody></table></div>"
                },
                "title": "Urinalysis"
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              {
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                  "text": "Specimen information"
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                    "reference": "urn:uuid:3abf114c-99f2-41e8-8370-32fde0a10cc4"
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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>17-NOV-2022</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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              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Annotation</h3><table class=\"hl7__eu__lab__report\"><tr><th>Conclusion and Recommendations based on this report and previous findings known to us</th></tr><tr><td>The patient shows elevated serum creatinine, low CO₂, high chloride, and significant proteinuria, suggesting possible renal impairment with metabolic acidosis. Urinalysis reveals glucosuria, ketonuria, and bilirubinuria despite normal serum glucose and low HbA1c, which may indicate tubular dysfunction rather than diabetes. Cloudy, brown urine with low specific gravity further supports renal involvement. Recommend nephrology evaluation and further workup for underlying renal pathology.</td></tr></table></div>"
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        ],
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          {
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                "display": "Proteinuria due to type 2 diabetes mellitus"
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              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "display": "Potassium [Moles/volume] in Serum or Plasma"
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              "display": "Chloride [Moles/volume] in Serum or Plasma"
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        ],
        "interpretation": [
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            "coding": [
              {
                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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            ]
          }
        ],
        "text": {
          "status": "generated",
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        },
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          "reference": "urn:uuid:61ae31bf-6c31-4482-b8b6-19b028c04ac4"
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      }
    },
    {
      "fullUrl": "urn:uuid:2a80e7fa-3212-4335-beea-5fb58441cb69",
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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": "2028-9",
              "system": "http://loinc.org",
              "display": "Carbon dioxide, total [Moles/volume] in Serum or Plasma"
            }
          ],
          "text": "Carbon dioxide, total [Moles/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 20.3,
          "unit": "mmol/L",
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        "referenceRange": [
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            "low": {
              "value": 22,
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            },
            "high": {
              "value": 32,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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        ],
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                "code": "L",
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                "display": "Low"
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            ]
          }
        ],
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        },
        "status": "final",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5767-9",
              "system": "http://loinc.org",
              "display": "Appearance of Urine"
            }
          ],
          "text": "Appearance of Urine"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Appearance of Urine</td><td>Cloudy urine</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
            {
              "code": "7766007",
              "system": "http://snomed.info/sct",
              "display": "Cloudy urine"
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          ]
        },
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    },
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        },
        "category": [
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            ]
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "34533-0",
              "system": "http://loinc.org",
              "display": "Odor of Urine"
            }
          ],
          "text": "Odor of Urine"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Odor of Urine</td><td>Urine smell ammoniacal</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
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              "display": "Urine smell ammoniacal"
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          ]
        },
        "specimen": {
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      }
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        "category": [
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            ]
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "32167-9",
              "system": "http://loinc.org",
              "display": "Clarity of Urine"
            }
          ],
          "text": "Clarity of Urine"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Clarity of Urine</td><td>Translucent</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
            {
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              "display": "Translucent"
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          ]
        },
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      }
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        "code": {
          "coding": [
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              "code": "5778-6",
              "system": "http://loinc.org",
              "display": "Color of Urine"
            }
          ],
          "text": "Color of Urine"
        },
        "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>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Color of Urine</td><td>Brown color</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Tom Hayward"
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "371254008",
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              "display": "Brown color"
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          ]
        },
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        },
        "category": [
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5792-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Urine by Test strip"
            }
          ],
          "text": "Glucose [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 1,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
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            "high": {
              "value": 5,
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              "system": "http://unitsofmeasure.org"
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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>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>1.0</td><td>0 - 5</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "specimen": {
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        "code": {
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              "code": "25428-4",
              "system": "http://loinc.org",
              "display": "Glucose [Presence] in Urine by Test strip"
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          ],
          "text": "Glucose [Presence] in Urine by Test strip"
        },
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>Urine glucose test = ++</td></tr></table></div>"
        },
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        "valueCodeableConcept": {
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              "code": "167265006",
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              "display": "Urine glucose test = ++"
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        ],
        "code": {
          "coding": [
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              "code": "20505-4",
              "system": "http://loinc.org",
              "display": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 0.4,
          "unit": "mg/dL",
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        "referenceRange": [
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        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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              "code": "5770-3",
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              "display": "Bilirubin.total [Presence] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Presence] in Urine by Test strip"
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        "valueCodeableConcept": {
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        "code": {
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              "display": "Ketones [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Ketones [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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          "value": 8.5,
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          }
        ],
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              "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>17-Nov-2022</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",
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        "valueCodeableConcept": {
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        "code": {
          "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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              "value": 1.03,
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        ],
        "text": {
          "status": "generated",
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        "code": {
          "coding": [
            {
              "code": "5803-2",
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              "display": "pH of Urine by Test strip"
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          ],
          "text": "pH of Urine by Test strip"
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        "valueQuantity": {
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          "value": 6.9,
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              "code": "pH",
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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>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>6.9</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
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        "specimen": {
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    {
      "fullUrl": "urn:uuid:6bced00b-93d8-46c7-8cc8-5194c5b782ff",
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        "id": "6bced00b-93d8-46c7-8cc8-5194c5b782ff",
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        "category": [
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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": 295.6,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
          {
            "low": {
              "value": 0,
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            },
            "high": {
              "value": 20,
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              "system": "http://unitsofmeasure.org"
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                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>295.6</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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      "fullUrl": "urn:uuid:60298582-a490-410e-bb35-8fc00f89f57d",
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        "code": {
          "coding": [
            {
              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</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": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = ++"
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        ],
        "code": {
          "coding": [
            {
              "code": "5802-4",
              "system": "http://loinc.org",
              "display": "Nitrite [Presence] in Urine by Test strip"
            }
          ],
          "text": "Nitrite [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>17-Nov-2022</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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        "valueCodeableConcept": {
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              "display": "Urine nitrite negative"
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        ],
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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>17-Nov-2022</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "167297006",
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              "display": "Urine blood test = negative"
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        "specimen": {
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      }
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    {
      "fullUrl": "urn:uuid:438fc62d-c54f-469e-9946-7a6d8db171f7",
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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>17-Nov-2022</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": "Tom Hayward"
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "394717006",
              "system": "http://snomed.info/sct",
              "display": "Urine leukocyte test negative"
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          ]
        },
        "specimen": {
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      }
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    {
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        "id": "a09df287-60e8-4fbf-abeb-85802f714b2d",
        "meta": {
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        "category": [
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        ],
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            "display": "The Central European Lab"
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        ],
        "code": {
          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
            }
          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 3.3,
          "unit": "%",
          "code": "%"
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        "referenceRange": [
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              "system": "http://unitsofmeasure.org"
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            "high": {
              "value": 5.6,
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                "display": "Low"
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            ]
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        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "effectiveDateTime": "2022-11-17T06:17:44Z",
        "specimen": {
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    {
      "fullUrl": "urn:uuid:68e6b345-db58-48fb-99d1-9550de148d48",
      "resource": {
        "resourceType": "Device",
        "id": "68e6b345-db58-48fb-99d1-9550de148d48",
        "deviceName": [
          {
            "name": "SYNDERAI Synthetic Generator",
            "type": "manufacturer-name"
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        ],
        "version": [
          {
            "value": "5.0"
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">SYNDERAI Synthetic Generator v5.0</div>"
        },
        "status": "active",
        "distinctIdentifier": "synderai-generator-50",
        "manufacturer": "SYNDERAI Project"
      }
    },
    {
      "fullUrl": "urn:uuid:1a764240-6972-41df-8747-65aeda2c945f",
      "resource": {
        "resourceType": "Provenance",
        "id": "1a764240-6972-41df-8747-65aeda2c945f",
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          {
            "reference": "urn:uuid:f585a635-0ddf-4ff6-b4ed-1b3ab4f32e54"
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          {
            "reference": "urn:uuid:068d5a38-ab88-497e-ac21-5ecf994519a4"
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          {
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        "activity": {
          "coding": [
            {
              "code": "CREATE",
              "system": "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
              "display": "create"
            }
          ],
          "text": "Synthetic Example Data Generation"
        },
        "policy": [
          "https://synderai.net/synderai-synthetic-data-policy"
        ],
        "agent": [
          {
            "type": {
              "coding": [
                {
                  "code": "author",
                  "system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                  "display": "Author"
                }
              ],
              "text": "author"
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            "who": {
              "reference": "urn:uuid:68e6b345-db58-48fb-99d1-9550de148d48"
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        ],
        "reason": [
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            "coding": [
              {
                "code": "TRAIN",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
                "display": "training"
              }
            ],
            "text": "Interoperability Testing and Training (non-clinical use)"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provenance for SYNDERAI Synthetic Example Data Resource</div>"
        },
        "recorded": "2022-11-17T07:17:44Z"
      }
    },
    {
      "fullUrl": "urn:uuid:f585a635-0ddf-4ff6-b4ed-1b3ab4f32e54",
      "resource": {
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        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu"
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        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: f585a635-0ddf-4ff6-b4ed-1b3ab4f32e54</div>"
        },
        "practitioner": {
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    {
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            "postalCode": "1000",
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        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
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  ],
  "type": "document",
  "timestamp": "2022-11-17T07:17:44Z"
}