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                    "reference": "urn:uuid:7bd4e6d0-e7d9-4b78-a9de-1964371b695a"
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                  {
                    "reference": "urn:uuid:f67fe40b-2c38-4ef9-aa83-621aa09bf51a"
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                  {
                    "reference": "urn:uuid:5371fc04-fbae-466c-a2dc-180b2bfdd9df"
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                    "reference": "urn:uuid:e7831b6e-4d4e-40ba-8669-8c69168f138b"
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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>08-SEP-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>83.2</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>12.1</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>9.8</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.4</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>105.1</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td><strong>20.6 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>2.9 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>83.2</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>12.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>3.0 H</strong></td><td>0.7 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.8</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>138.4</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>105.1</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td><strong>20.6 L</strong></td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
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                  "coding": [
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                      "display": "Urinalysis studies (set)"
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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>08-SEP-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><strong>1.5 H</strong></td><td>0 - 0.8</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><strong>0.7 H</strong></td><td>0.0 - 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>18.3 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>5.8</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>198.8 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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                  "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>08-SEP-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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              "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, proteinuria, glucosuria, ketonuria, and bilirubinuria, with low urine specific gravity and metabolic acidosis (low CO₂). These findings suggest significant renal impairment, likely acute or chronic kidney disease, with possible tubular dysfunction. The urine appearance (cloudy, brown, ammoniacal) may indicate underlying infection or hematuria, though leukocyte esterase and nitrites are negative. Very low HbA1c is unusual and may reflect anemia or lab error. Recommend urgent nephrology evaluation and further clinical correlation.</td></tr></table></div>"
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:3f95225a-ad9e-4329-a876-96cb991f6d3a",
          "display": "Yves Rémy"
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        "date": "2019-09-08T07:32:03Z",
        "title": "Laboratory Report",
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            "postalCode": "06400",
            "city": "Cannes",
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        ],
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            ],
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          {
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        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Clinique du Méridien</div>"
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        "name": "Clinique du Méridien"
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        },
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        },
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "system": "http://unitsofmeasure.org"
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              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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        "specimen": {
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              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "unit": "mmol/L",
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              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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      "fullUrl": "urn:uuid:43fcf5dd-6b9d-4e16-b0d3-e1dc1efbc86c",
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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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          "unit": "mmol/L",
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              "value": 5.1,
              "code": "mmol/L",
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      }
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            {
              "code": "2075-0",
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              "display": "Chloride [Moles/volume] in Serum or Plasma"
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          ],
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              "code": "2028-9",
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              "display": "Carbon dioxide, total [Moles/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 20.6,
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              "code": "5767-9",
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              "display": "Appearance of Urine"
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          ],
          "text": "Appearance of Urine"
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        },
        "status": "final",
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        ],
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        ],
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              "code": "34533-0",
              "system": "http://loinc.org",
              "display": "Odor of Urine"
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          ],
          "text": "Odor of Urine"
        },
        "text": {
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        "code": {
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              "code": "32167-9",
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              "display": "Clarity of Urine"
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          ],
          "text": "Clarity of Urine"
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              "display": "Color of Urine"
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          ],
          "text": "Color of Urine"
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        "text": {
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        },
        "status": "final",
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        "effectiveDateTime": "2019-09-08T05:32:03Z",
        "valueCodeableConcept": {
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              "display": "Brown color"
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              "display": "Glucose [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Glucose [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 1.5,
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        ],
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        },
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              "code": "25428-4",
              "system": "http://loinc.org",
              "display": "Glucose [Presence] in Urine by Test strip"
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          ],
          "text": "Glucose [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>08-Sep-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>Urine glucose test = ++</td></tr></table></div>"
        },
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        "effectiveDateTime": "2019-09-08T05:32:03Z",
        "valueCodeableConcept": {
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        "code": {
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              "code": "20505-4",
              "system": "http://loinc.org",
              "display": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 0.7,
          "unit": "mg/dL",
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        "referenceRange": [
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            "high": {
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                "display": "High"
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            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>08-Sep-2019</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Bilirubin.total [Mass/volume] in Urine by Test strip</td><td>0.7</td><td>0.0 - 0.4</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2019-09-08T05:32:03Z",
        "specimen": {
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        ],
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        "code": {
          "coding": [
            {
              "code": "5770-3",
              "system": "http://loinc.org",
              "display": "Bilirubin.total [Presence] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Presence] in Urine by Test strip"
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        "text": {
          "status": "generated",
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        "effectiveDateTime": "2019-09-08T05:32:03Z",
        "valueCodeableConcept": {
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        "category": [
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          }
        ],
        "performer": [
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        ],
        "code": {
          "coding": [
            {
              "code": "5797-6",
              "system": "http://loinc.org",
              "display": "Ketones [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Ketones [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 18.3,
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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": "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": {
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          "value": 198.8,
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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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          ],
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            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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  "timestamp": "2019-09-08T07:32:03Z"
}