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                    "reference": "urn:uuid:5e383fd1-98ca-473c-b46b-898bffd107ec"
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                  {
                    "reference": "urn:uuid:c34aeaa9-389f-4fb9-ac40-e0f247145b3a"
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                  {
                    "reference": "urn:uuid:4c6b3ae4-acf2-42c0-af8b-9f146f549ae5"
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                  {
                    "reference": "urn:uuid:c0bee6a4-9b8c-49a7-9a2f-ac6d24485c32"
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                    "reference": "urn:uuid:58bcd1aa-add8-4982-8a1c-a423ae1f8121"
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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>27-SEP-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>83.7</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>14.9</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.1 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>9.7</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>136.7</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>106.7</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>27.4</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>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>83.7</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>14.9</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>1.7 H</strong></td><td>0.7 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.7</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>136.7</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</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 Blood</td><td>106.7</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>27.4</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
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                  "coding": [
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                  "text": "Urinalysis"
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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>27-SEP-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><strong>1.0 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>1.1 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>8.9 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>6.8</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>236.2 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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              {
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                  "text": "Specimen information"
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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>27-SEP-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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              "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 creatinine, potassium, and significant proteinuria, suggesting impaired renal function. Urine findings (cloudy, brown, low specific gravity, high protein, glucose, bilirubin, and ketones) indicate possible nephrotic syndrome or acute kidney injury. Low HbA1c excludes chronic hyperglycemia. No evidence of urinary tract infection. Recommend urgent nephrology evaluation and further assessment for underlying renal pathology.</td></tr></table></div>"
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        "status": "final",
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          "reference": "urn:uuid:8410be36-e17b-4e4d-b1db-91aae8e61bfb",
          "display": "Yves Rémy"
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        "date": "2020-09-27T07:32:03Z",
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          "display": "Yves Rémy"
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            "city": "Cannes",
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                  ]
                }
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            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        "identifier": [
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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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        },
        "collection": {
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              "display": "Glucose [Mass/volume] in Serum or Plasma"
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          ],
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            "high": {
              "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>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>83.7</td><td>70 - 100</td><td></td><td>mg/dL</td></tr></table></div>"
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              "code": "3094-0",
              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "code": "mg/dL",
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              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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          ],
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          "unit": "mg/dL",
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          }
        ],
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          "display": "Yves Rémy"
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        "specimen": {
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      "fullUrl": "urn:uuid:9265bc41-dbf2-4265-8ba0-faad74dda69d",
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              "code": "2951-2",
              "system": "http://loinc.org",
              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "text": "Sodium [Moles/volume] in Serum or Plasma"
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          "value": 136.7,
          "unit": "mmol/L",
          "code": "mmol/L"
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            "high": {
              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>136.7</td><td>135 - 145</td><td></td><td>mmol/L</td></tr></table></div>"
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        "status": "final",
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        "specimen": {
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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"
        },
        "valueQuantity": {
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          "value": 5.2,
          "unit": "mmol/L",
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
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            ]
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        ],
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          "text": "Ketones [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 8.9,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
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            "low": {
              "value": 0,
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 4,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
        "interpretation": [
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            "coding": [
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                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
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            ]
          }
        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Mass/volume] in Urine by Test strip</td><td>8.9</td><td>0 - 4</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "specimen": {
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                "code": "laboratory",
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            ]
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
            }
          ],
          "text": "Ketones [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = +</td></tr></table></div>"
        },
        "status": "final",
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        "valueCodeableConcept": {
          "coding": [
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              "code": "167289004",
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              "display": "Urine ketone test = +"
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      }
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5811-5",
              "system": "http://loinc.org",
              "display": "Specific gravity of Urine by Test strip"
            }
          ],
          "text": "Specific gravity of Urine by Test strip"
        },
        "valueQuantity": {
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          "value": 1,
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          "code": "1"
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        "referenceRange": [
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            "low": {
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              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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            "high": {
              "value": 1.03,
              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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          }
        ],
        "interpretation": [
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                "code": "L",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "Low"
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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>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Specific gravity of Urine by Test strip</td><td>1.0</td><td>1.005 - 1.030</td><td>L</td><td>{nominal}</td></tr></table></div>"
        },
        "status": "final",
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        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:86e12d51-f41b-4445-953a-0a6de19341ed",
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        "meta": {
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        "category": [
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                "code": "laboratory",
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            ]
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5803-2",
              "system": "http://loinc.org",
              "display": "pH of Urine by Test strip"
            }
          ],
          "text": "pH of Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 6.8,
          "unit": "pH",
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        "referenceRange": [
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            "low": {
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              "code": "pH",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 8,
              "code": "pH",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>6.8</td><td>4.5 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:8410be36-e17b-4e4d-b1db-91aae8e61bfb",
          "display": "Yves Rémy"
        },
        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "specimen": {
          "reference": "urn:uuid:9ec63d23-b716-4ef1-8d26-56fc201cede7"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:527d41f5-0dac-44ff-b758-6405d246fc2b",
      "resource": {
        "resourceType": "Observation",
        "id": "527d41f5-0dac-44ff-b758-6405d246fc2b",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/laboratory/StructureDefinition/Observation-resultslab-eu-lab"
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        },
        "category": [
          {
            "coding": [
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                "code": "laboratory",
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            ]
          }
        ],
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            "display": "The Central European Lab"
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        ],
        "code": {
          "coding": [
            {
              "code": "5804-0",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Urine by Test strip"
            }
          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 236.2,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
          {
            "low": {
              "value": 0,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "interpretation": [
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            "coding": [
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                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
              }
            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>236.2</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:60647ac3-c3f9-4d7e-967a-f9851ee6214c",
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        "category": [
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            ]
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
            }
          ],
          "text": "Protein [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = ++</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = ++"
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        "code": {
          "coding": [
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              "code": "5802-4",
              "system": "http://loinc.org",
              "display": "Nitrite [Presence] in Urine by Test strip"
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          ],
          "text": "Nitrite [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "valueCodeableConcept": {
          "coding": [
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              "display": "Urine nitrite negative"
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    {
      "fullUrl": "urn:uuid:73828480-35a9-4a8b-a8c9-dafa47ad2951",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5794-3",
              "system": "http://loinc.org",
              "display": "Hemoglobin [Presence] in Urine by Test strip"
            }
          ],
          "text": "Hemoglobin [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</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>"
        },
        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "valueCodeableConcept": {
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              "display": "Urine blood test = negative"
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5799-2",
              "system": "http://loinc.org",
              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
            }
          ],
          "text": "Leukocyte esterase [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>27-Sep-2020</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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        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "valueCodeableConcept": {
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        "meta": {
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        ],
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        "code": {
          "coding": [
            {
              "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": 3.1,
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          }
        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "effectiveDateTime": "2020-09-27T05:32:03Z",
        "specimen": {
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        ],
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        ],
        "code": {
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            {
              "code": "2339-0",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Blood"
            }
          ],
          "text": "Glucose [Mass/volume] in Blood"
        },
        "valueQuantity": {
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          "value": 83.7,
          "unit": "mg/dL",
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        "referenceRange": [
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            },
            "high": {
              "value": 100,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
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        "recorded": "2020-09-27T07:32:03Z"
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        "text": {
          "status": "generated",
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            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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        ],
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  "type": "document",
  "timestamp": "2020-09-27T07:32:03Z"
}