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                    "reference": "urn:uuid:3fea6870-2f98-4212-a776-f380dfed1230"
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                  {
                    "reference": "urn:uuid:393bf5f3-b476-4274-bddd-ea6de216ce8f"
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                  {
                    "reference": "urn:uuid:c898d392-7581-4506-8683-11d83367fd2b"
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                  {
                    "reference": "urn:uuid:4391e335-4ae7-4901-a92c-d5466f617008"
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                    "reference": "urn:uuid:1fbc099d-8d9e-4f3a-ace2-89a0f929f5b2"
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                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>16-AUG-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>86.3</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>15.4</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>8.7</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>137.7</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.9</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>106.2</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td><strong>21.6 L</strong></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>3.1 L</strong></td><td>4.8 - 5.9</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>86.3</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>15.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>1.8 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>8.7</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>137.7</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.9</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>106.2</td><td>98 - 110</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td><strong>21.6 L</strong></td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
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                  "text": "Urinalysis"
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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>16-AUG-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>2.4</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>0.8</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>18.9 H</strong></td><td>0 - 4</td><td>mg/dL</td></tr><tr><td>Specific gravity of Urine by Test strip</td><td><strong>1.0 L</strong></td><td>1.005 - 1.030</td><td>{nominal}</td></tr><tr><td>pH of Urine by Test strip</td><td>5.3</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>341.7 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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              {
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                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Specimen information</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>16-AUG-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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              "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 creatinine, low total CO₂, and significant proteinuria, suggesting possible renal impairment with metabolic acidosis. Urine findings (cloudy, brown, low specific gravity, proteinuria, ketonuria, glucosuria) further support renal dysfunction, possibly nephrotic syndrome or acute kidney injury. HbA1c is unexpectedly low despite glucosuria; consider lab artifact or hemoglobinopathy. Recommend nephrology evaluation and further assessment for underlying causes.</td></tr></table></div>"
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          "display": "Ahmed Wirth"
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        "date": "2020-08-16T01:37:39Z",
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            "use": "home",
            "type": "physical",
            "postalCode": "96317",
            "city": "Kronach",
            "country": "Germany"
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        ],
        "telecom": [
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            "value": "06478333493"
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        ],
        "extension": [
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
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            ]
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          {
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            ]
          },
          {
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            ]
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          {
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          {
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        "status": "active",
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        ],
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        },
        "name": "Medizinisches Versorgungszentrum Kronach"
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          ]
        },
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        },
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              "display": "Acellular blood (serum or plasma) specimen"
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        },
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        },
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              "display": "Whole blood specimen (specimen)"
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              "code": "2345-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "value": 100,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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          }
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>16-Aug-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>86.3</td><td>70 - 100</td><td></td><td>mg/dL</td></tr></table></div>"
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        "status": "final",
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        "specimen": {
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              "code": "3094-0",
              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
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        },
        "status": "final",
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            ]
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          "status": "generated",
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              "code": "17861-6",
              "system": "http://loinc.org",
              "display": "Calcium [Mass/volume] in Serum or Plasma"
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          "text": "Calcium [Mass/volume] in Serum or Plasma"
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          "value": 8.7,
          "unit": "mg/dL",
          "code": "mg/dL"
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        ],
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        "specimen": {
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              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "value": 137.7,
          "unit": "mmol/L",
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              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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        ],
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        "code": {
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              "code": "2823-3",
              "system": "http://loinc.org",
              "display": "Potassium [Moles/volume] in Serum or Plasma"
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          ],
          "text": "Potassium [Moles/volume] in Serum or Plasma"
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          "value": 4.9,
          "unit": "mmol/L",
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              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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          }
        ],
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        "status": "final",
        "subject": {
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              "display": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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          ],
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        "valueQuantity": {
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              "display": "Ketones [Mass/volume] in Urine by Test strip"
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          ],
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        "valueQuantity": {
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            ]
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        ],
        "text": {
          "status": "generated",
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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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    {
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        "meta": {
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        "code": {
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              "code": "5804-0",
              "system": "http://loinc.org",
              "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": {
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          "value": 341.7,
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        "referenceRange": [
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        ],
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              "code": "20454-5",
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          "text": "Protein [Presence] in Urine by Test strip"
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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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              "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": "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"
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        "text": {
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              "code": "4548-4",
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              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
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        ],
        "text": {
          "status": "generated",
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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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          "value": 86.3,
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            "high": {
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        ],
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          "status": "generated",
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            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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  "timestamp": "2020-08-16T01:37:39Z"
}