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                "code": {
                  "coding": [
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                    "reference": "urn:uuid:598e7ad8-eb1f-493a-9255-087f92decaa7"
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                    "reference": "urn:uuid:b464fadb-327b-4696-a4ac-35c958267ed2"
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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>10-OCT-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>85.6</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.6</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>8.7</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>140.0</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.7</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>103.7</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>23.2</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>3.0 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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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>10-OCT-2018</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>2.0</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>1.2</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>12.6 H</strong></td><td>0 - 4</td><td>mg/dL</td></tr><tr><td>Specific gravity of Urine by Test strip</td><td><strong>1.0 L</strong></td><td>1.005 - 1.030</td><td>{nominal}</td></tr><tr><td>pH of Urine by Test strip</td><td>6.0</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>186.6 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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                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:cb39f6c3-8232-495a-9845-353b4d015def"
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                    "reference": "urn:uuid:ae719588-2369-40a8-8384-ba78a3540f6e"
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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>10-OCT-2018</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>Renal function is impaired (elevated creatinine), with significant proteinuria and ketonuria, low urine specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal). Blood glucose and HbA1c are low, suggesting no hyperglycemia. No evidence of urinary tract infection (negative nitrites/leukocytes). Findings are consistent with possible chronic kidney disease and protein-losing nephropathy; consider further nephrological evaluation and assessment for underlying causes.</td></tr></table></div>"
            },
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          "status": "empty",
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        "status": "final",
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          "display": "Patricia Joubert"
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        "date": "2018-10-10T08:42:07Z",
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          "reference": "urn:uuid:1c5c50c8-5aac-406a-814b-5b8dc0082118",
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              "code": "TRAIN"
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              "code": "synthetic",
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                  "code": "JHN",
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            "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": [
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            "given": [
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            "text": "Patricia Joubert"
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        ],
        "address": [
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            "line": [
              "7, chemin Lenoir"
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            "use": "home",
            "type": "physical",
            "postalCode": "50570",
            "city": "Delahaye-la-Forêt",
            "country": "France"
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        ],
        "telecom": [
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            "value": "0760047035"
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        "extension": [
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            "extension": [
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
        "text": {
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          "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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        ],
        "reasonCode": [
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            "coding": [
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                "code": "433144002",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 3"
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            ]
          },
          {
            "coding": [
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                "code": "157141000119108",
                "system": "http://snomed.info/sct",
                "display": "Proteinuria due to type 2 diabetes mellitus"
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          },
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                "code": "431856006",
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                "display": "Chronic kidney disease stage 2"
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            ]
          },
          {
            "coding": [
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                "code": "90781000119102",
                "system": "http://snomed.info/sct",
                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
          },
          {
            "coding": [
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                "code": "26929004",
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                "display": "Alzheimer's disease"
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            ]
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          {
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                "display": "Acute ST segment elevation myocardial infarction"
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          {
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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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          "value": 186.6,
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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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        "code": {
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              "code": "5794-3",
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              "display": "Hemoglobin [Presence] in Urine by Test strip"
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          ],
          "text": "Hemoglobin [Presence] in Urine by Test strip"
        },
        "text": {
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>10-Oct-2018</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": "Urine blood test = negative"
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        "code": {
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            {
              "code": "5799-2",
              "system": "http://loinc.org",
              "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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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>10-Oct-2018</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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        "valueCodeableConcept": {
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              "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"
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        "valueQuantity": {
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          "value": 3,
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        "specimen": {
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    {
      "fullUrl": "urn:uuid:c6749b3a-956d-44d8-8b1b-39c4ca9de738",
      "resource": {
        "resourceType": "Device",
        "id": "c6749b3a-956d-44d8-8b1b-39c4ca9de738",
        "deviceName": [
          {
            "name": "SYNDERAI Synthetic Generator",
            "type": "manufacturer-name"
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        ],
        "version": [
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            "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"
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    },
    {
      "fullUrl": "urn:uuid:0abb175e-e4ae-47aa-9ee1-3a126e5efd18",
      "resource": {
        "resourceType": "Provenance",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
              "display": "create"
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          ],
          "text": "Synthetic Example Data Generation"
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        "policy": [
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        "agent": [
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                  "display": "Author"
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              ],
              "text": "author"
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        "reason": [
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              {
                "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": "2018-10-10T08:42:07Z"
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    {
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        "meta": {
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        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: a531c929-f5aa-446c-9e04-2f2d6ab4e234</div>"
        },
        "practitioner": {
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      "resource": {
        "resourceType": "Practitioner",
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        "identifier": [
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            "assigner": {
              "display": "HL7 Europe"
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            "system": "urn:oid:2.16.840.1.113883.2.51.999",
            "value": "093b4a8c-b3f0-4f6f-a3a4-db0248a18089"
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        ],
        "name": [
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            "given": [
              "Ex"
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            "family": "Ample"
          }
        ],
        "address": [
          {
            "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": "2018-10-10T08:42:07Z"
}