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                  {
                    "reference": "urn:uuid:fc9586c5-d458-455d-b6f2-8aeb2401babd"
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                  {
                    "reference": "urn:uuid:ce648ae5-5053-481e-85cf-263c00dc8dac"
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                  {
                    "reference": "urn:uuid:66f33304-1733-419d-8dda-228cc5622a09"
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                  {
                    "reference": "urn:uuid:cc4ae926-f5d5-4061-852f-612f5b5232a6"
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                  {
                    "reference": "urn:uuid:105841c8-d6d9-4a9b-a9f3-1cd7882f9a5e"
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                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>13-SEP-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td><strong>66.9 L</strong></td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.0 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>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>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>3.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>109.1 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>28.4</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>2.8 L</strong></td><td>4.8 - 5.9</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td><strong>66.9 L</strong></td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>12.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>2.2 H</strong></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>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>3.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>109.1</td><td>98 - 110</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>28.4</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
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                      "display": "Urinalysis studies (set)"
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                  "text": "Urinalysis"
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                "text": {
                  "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>13-SEP-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>0.7</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>1.3</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>9.7 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>6.4</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>160.6 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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              {
                "code": {
                  "coding": [
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                      "system": "http://loinc.org",
                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                "text": {
                  "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>13-SEP-2020</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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            "text": {
              "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 hypoglycemia, low HbA1c, and elevated creatinine, suggesting impaired renal function. Urinalysis reveals proteinuria, ketonuria, bilirubinuria, low specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal), indicating possible nephrotic syndrome or significant renal pathology. No evidence of urinary tract infection. Recommend urgent clinical evaluation for renal dysfunction and further assessment of hypoglycemia etiology.</td></tr></table></div>"
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        "subject": {
          "reference": "urn:uuid:54ede757-c69f-4203-b9aa-5ae633bd2c05",
          "display": "Ahmed Wirth"
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        "date": "2020-09-13T01:37:39Z",
        "title": "Laboratory Report",
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            "use": "home",
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            "postalCode": "96317",
            "city": "Kronach",
            "country": "Germany"
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        ],
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            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Ahmed Wirth</td><td>male</td><td>02-Oct-1948</td></tr></table></div>"
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        "gender": "male",
        "birthDate": "1948-10-02"
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    {
      "fullUrl": "urn:uuid:778f2fdd-f2a8-41ba-a64f-45872a2f6bc8",
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        "resourceType": "ServiceRequest",
        "id": "778f2fdd-f2a8-41ba-a64f-45872a2f6bc8",
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          "profile": [
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          {
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        ],
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            ]
          },
          {
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              {
                "code": "431856006",
                "system": "http://snomed.info/sct",
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            ]
          },
          {
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            ]
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          {
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                "system": "http://snomed.info/sct",
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          {
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                "system": "http://snomed.info/sct",
                "display": "Chronic sinusitis"
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          },
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          {
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                "code": "59621000",
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          {
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              {
                "code": "271737000",
                "system": "http://snomed.info/sct",
                "display": "Anemia"
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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",
        "code": {
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              "code": "108252007",
              "system": "http://snomed.info/sct",
              "display": "Laboratory procedure"
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        "resourceType": "PractitionerRole",
        "id": "431afccb-a7f6-4e0d-b402-908f7d303a07",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu"
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        "text": {
          "status": "generated",
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        "organization": {
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          {
            "assigner": {
              "display": "HL7 Europe"
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            "system": "urn:oid:2.16.840.1.113883.2.51.999",
            "value": "cc49f51f-b003-452e-9711-5472e2ab66d6"
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          {
            "line": [
              "Friesener Straße 41"
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            "city": "Kronach",
            "postalCode": "96317",
            "country": "Germany"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Medizinisches Versorgungszentrum Kronach</div>"
        },
        "name": "Medizinisches Versorgungszentrum Kronach"
      }
    },
    {
      "fullUrl": "urn:uuid:e9a77e82-c935-4cfc-9719-b8bf7ac05997",
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          ]
        },
        "collection": {
          "collectedDateTime": "2020-09-12"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Acellular blood (serum or plasma) specimen</td><td><span class=\"nb\">12-Sep-2020</span></td></tr></table></div>"
        },
        "type": {
          "coding": [
            {
              "code": "122592007",
              "system": "http://snomed.info/sct",
              "display": "Acellular blood (serum or plasma) specimen"
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      }
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    {
      "fullUrl": "urn:uuid:274aed60-c616-4e8e-9f0b-50ce08a76416",
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          ]
        },
        "collection": {
          "collectedDateTime": "2020-09-12"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Urine specimen</td><td><span class=\"nb\">12-Sep-2020</span></td></tr></table></div>"
        },
        "type": {
          "coding": [
            {
              "code": "122575003",
              "system": "http://snomed.info/sct",
              "display": "Urine specimen"
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    {
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        "collection": {
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        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Whole blood specimen (specimen)</td><td><span class=\"nb\">12-Sep-2020</span></td></tr></table></div>"
        },
        "type": {
          "coding": [
            {
              "code": "258580003",
              "system": "http://snomed.info/sct",
              "display": "Whole blood specimen (specimen)"
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          ]
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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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          "value": 66.9,
          "unit": "mg/dL",
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              "code": "mg/dL",
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            "high": {
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
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              {
                "code": "L",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>66.9</td><td>70 - 100</td><td>L</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "specimen": {
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    {
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            "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
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        "category": [
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                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
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        ],
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            "display": "The Central European Lab"
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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"
            }
          ],
          "text": "Urea nitrogen [Mass/volume] in Serum or Plasma"
        },
        "valueQuantity": {
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          "value": 12.4,
          "unit": "mg/dL",
          "code": "mg/dL"
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              "value": 7,
              "code": "mg/dL",
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            },
            "high": {
              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "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>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.4</td><td>7 - 20</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2020-09-12T23:37:39Z",
        "specimen": {
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    {
      "fullUrl": "urn:uuid:780dbf94-5156-4a99-92b0-e9ba0693404c",
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        "category": [
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              "system": "http://loinc.org",
              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Creatinine [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 2,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
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              "value": 1.3,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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                "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>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td>2.0</td><td>0.6 - 1.3</td><td>H</td><td>mg/dL</td></tr></table></div>"
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        "status": "final",
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        "specimen": {
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    {
      "fullUrl": "urn:uuid:7b97c356-8666-447e-88de-20aa810a4880",
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        ],
        "code": {
          "coding": [
            {
              "code": "17861-6",
              "system": "http://loinc.org",
              "display": "Calcium [Mass/volume] in Serum or Plasma"
            }
          ],
          "text": "Calcium [Mass/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 8.8,
          "unit": "mg/dL",
          "code": "mg/dL"
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              "code": "mg/dL",
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            },
            "high": {
              "value": 10.3,
              "code": "mg/dL",
              "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>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>8.8</td><td>8.6 - 10.3</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "specimen": {
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      }
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    {
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        "meta": {
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        "category": [
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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"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 138.9,
          "unit": "mmol/L",
          "code": "mmol/L"
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              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 145,
              "code": "mmol/L",
              "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>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.9</td><td>135 - 145</td><td></td><td>mmol/L</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2020-09-12T23:37:39Z",
        "specimen": {
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    {
      "fullUrl": "urn:uuid:8573d4f9-b43e-4303-8b0d-5dfd3f4c0f63",
      "resource": {
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        "id": "8573d4f9-b43e-4303-8b0d-5dfd3f4c0f63",
        "meta": {
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        "category": [
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                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
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        ],
        "performer": [
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        ],
        "code": {
          "coding": [
            {
              "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"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 3.8,
          "unit": "mmol/L",
          "code": "mmol/L"
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        "referenceRange": [
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              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 5.1,
              "code": "mmol/L",
              "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>13-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>3.8</td><td>3.5 - 5.1</td><td></td><td>mmol/L</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2020-09-12T23:37:39Z",
        "specimen": {
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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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              "display": "pH of Urine by Test strip"
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        },
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    {
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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": {
          "system": "http://unitsofmeasure.org",
          "value": 160.6,
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        ],
        "text": {
          "status": "generated",
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              "code": "20454-5",
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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"
        },
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        "code": {
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            {
              "code": "5799-2",
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              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
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          ],
          "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>13-Sep-2020</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",
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              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
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        ],
        "text": {
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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": 66.9,
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            ]
          }
        ],
        "text": {
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        },
        "status": "final",
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            "postalCode": "1000",
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  "timestamp": "2020-09-13T01:37:39Z"
}