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                "code": {
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                      "code": "18719-5",
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                      "display": "Chemistry studies (set)"
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                "entry": [
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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>21-APR-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>95.7</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.8</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>0.5 - 1.1</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>8.6</td><td>8.6 - 10.2</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>136.4</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.1</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>109.3 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>24.7</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></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
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                      "code": "18729-4",
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                  {
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                    "reference": "urn:uuid:5739400d-283a-4dce-973e-ccd7cf1fc309"
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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>21-APR-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td><strong>0.9 H</strong></td><td>0 - 0</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>0.5</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>11.4</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>5.5</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>328.2 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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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:6eda895d-598a-4ddb-87bc-7d07546c0198"
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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>21-APR-2017</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 elevated serum creatinine, indicating impaired renal function, and significant proteinuria and glucosuria, suggesting possible glomerular damage or diabetic nephropathy. Urine is cloudy, brown, with low specific gravity, and contains bilirubin and ketones. No evidence of urinary tract infection (negative nitrite/leukocytes). Recommend further nephrological evaluation and assessment for diabetes and liver involvement.</td></tr></table></div>"
            },
            "code": {
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                  "code": "48767-8",
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        "subject": {
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          "display": "Angela Bauer"
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        "date": "2017-04-21T13:23:19Z",
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          "reference": "urn:uuid:a7ab4079-2d8e-46d1-9121-afa2ef055942",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
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              ]
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            "value": "9736-451235-6"
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                  "code": "MR",
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            "system": "http://local.setting.eu/identifier",
            "value": "ea91d0bd-b06d-03f2-3cd0-b401630c04cf"
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        ],
        "name": [
          {
            "given": [
              "Angela"
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            "family": "Bauer",
            "text": "Angela Bauer"
          }
        ],
        "address": [
          {
            "line": [
              "Kalina-Baumgartner-Gasse 8/9"
            ],
            "use": "home",
            "type": "physical",
            "postalCode": "6240",
            "city": "Rattenberg",
            "country": "Austria"
          }
        ],
        "telecom": [
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            "system": "phone",
            "value": "(06235) 28231 921"
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        ],
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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>Angela Bauer</td><td>female</td><td>08-Dec-1968</td></tr></table></div>"
        },
        "gender": "female",
        "birthDate": "1968-12-08"
      }
    },
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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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            ]
          },
          {
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                "code": "157141000119108",
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                "display": "Proteinuria due to type 2 diabetes mellitus"
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                "code": "237602007",
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                "display": "Metabolic syndrome X"
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            ]
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                "code": "239872002",
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                "display": "Osteoarthritis of hip"
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                "display": "Chronic kidney disease stage 2"
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            ]
          },
          {
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                "system": "http://snomed.info/sct",
                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
          },
          {
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                "system": "http://snomed.info/sct",
                "display": "Disorder of kidney due to diabetes mellitus"
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                "display": "Chronic kidney disease stage 1"
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                "display": "Essential hypertension"
              }
            ]
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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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            "text": "Interoperability Testing and Training (non-clinical use)"
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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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        "recorded": "2017-04-21T13:23:19Z"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: 57e76570-e711-4f9c-894a-1bfc1eff4424</div>"
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        "practitioner": {
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            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
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  "type": "document",
  "timestamp": "2017-04-21T13:23:19Z"
}