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                  "system": "http://loinc.org",
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                "code": {
                  "coding": [
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                      "system": "http://loinc.org",
                      "display": "Chemistry studies (set)"
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                    "reference": "urn:uuid:06f5da0c-4f25-4844-8904-85f83d1caafd"
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                  {
                    "reference": "urn:uuid:122c5a3c-1904-45d3-acc6-a13948680d8b"
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                    "reference": "urn:uuid:f300ef99-8591-4e18-b949-f06909357642"
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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>09-JAN-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>96.7</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>9.0</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</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 Serum or Plasma</td><td>8.6</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>140.4</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td><strong>5.2 H</strong></td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>110.0 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>23.0</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>3.2 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
                  "coding": [
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                    "reference": "urn:uuid:a7793715-95f2-494e-84d2-bcf3171c233b"
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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>09-JAN-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>0.9</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>0.2</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>8.3 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>6.8</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>234.7 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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                      "system": "http://loinc.org",
                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:5c0056c9-e3ac-460d-9434-924e01a38048"
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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>09-JAN-2019</th><th>Specimen</th><th></th></tr></thead><tbody><tr><td>Appearance of Urine</td><td>Cloudy urine</td><td>Urine</td><td></td></tr><tr><td>Odor of Urine</td><td>Urine smell ammoniacal</td><td>Urine</td><td></td></tr><tr><td>Clarity of Urine</td><td>Translucent</td><td>Urine</td><td></td></tr><tr><td>Color of Urine</td><td>Brown color</td><td>Urine</td><td></td></tr></tbody></table></div>"
                },
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            "title": "Laboratory Report"
          },
          {
            "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 elevated serum creatinine, potassium, and chloride, suggesting possible renal impairment and mild electrolyte imbalance. Urinalysis reveals significant proteinuria, ketonuria, glucosuria, low specific gravity, and abnormal urine appearance, indicating possible nephrotic syndrome or diabetic nephropathy, though HbA1c is low. No evidence of urinary infection. Recommend further renal evaluation and assessment for underlying metabolic or systemic disease.</td></tr></table></div>"
            },
            "code": {
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                  "code": "48767-8",
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                  "display": "Annotation comment [Interpretation] Narrative"
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        "text": {
          "status": "empty",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:5c54dc94-4cc3-426c-9559-0b3bd9ad9b9f",
          "display": "Patricia Joubert"
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        "date": "2019-01-09T07:42:07Z",
        "title": "Laboratory Report",
        "confidentiality": "N"
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            "reference": "urn:uuid:a7793715-95f2-494e-84d2-bcf3171c233b"
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        "status": "registered",
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          "reference": "urn:uuid:5c54dc94-4cc3-426c-9559-0b3bd9ad9b9f",
          "display": "Patricia Joubert"
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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          ],
          "tag": [
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              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
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          ],
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core"
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        },
        "identifier": [
          {
            "type": {
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                  "code": "JHN",
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            "system": "http://ec.europa.eu/identifier/eci",
            "value": "7843-162355-8"
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                  "code": "MR",
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            "system": "http://local.setting.eu/identifier",
            "value": "ba17a51d-e5e2-2da2-b64f-9361f1a480e6"
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        ],
        "name": [
          {
            "given": [
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            "family": "Joubert",
            "text": "Patricia Joubert"
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        ],
        "address": [
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            "line": [
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            "use": "home",
            "type": "physical",
            "postalCode": "50570",
            "city": "Delahaye-la-Forêt",
            "country": "France"
          }
        ],
        "telecom": [
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            "system": "phone",
            "value": "0760047035"
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        "extension": [
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            "extension": [
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                "url": "code",
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Patricia Joubert</td><td>female</td><td>10-Sep-1939</td></tr></table></div>"
        },
        "gender": "female",
        "birthDate": "1939-09-10"
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            "reference": "urn:uuid:a194fee1-7711-484e-8ead-e32f0a42d3ed"
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        ],
        "reasonCode": [
          {
            "coding": [
              {
                "code": "433144002",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 3"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "157141000119108",
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                "display": "Proteinuria due to type 2 diabetes mellitus"
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          {
            "coding": [
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                "code": "431856006",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 2"
              }
            ]
          },
          {
            "coding": [
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                "code": "90781000119102",
                "system": "http://snomed.info/sct",
                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
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          {
            "coding": [
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                "system": "http://snomed.info/sct",
                "display": "Alzheimer's disease"
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            ]
          },
          {
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                "system": "http://snomed.info/sct",
                "display": "Acute ST segment elevation myocardial infarction"
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          },
          {
            "coding": [
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                "display": "Disorder of kidney due to diabetes mellitus"
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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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              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
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          "text": "Leukocyte esterase [Presence] in Urine by Test strip"
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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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          "text": "Synthetic Example Data Generation"
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        "agent": [
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              "text": "author"
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                "display": "training"
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            ],
            "text": "Interoperability Testing and Training (non-clinical use)"
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        "text": {
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provenance for SYNDERAI Synthetic Example Data Resource</div>"
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              "display": "HL7 Europe"
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            "given": [
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          }
        ],
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          {
            "line": [
              "Laboratoire Central Européenne",
              "Boulevard du Jardin Botanique 32"
            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
        }
      }
    }
  ],
  "type": "document",
  "timestamp": "2019-01-09T07:42:07Z"
}
