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                    "reference": "urn:uuid:af3c22e9-d2b3-4db6-b1d1-fdb63c8a378b"
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                    "reference": "urn:uuid:991742f3-3864-454a-a962-bc45a985a9e7"
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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>12-JUL-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>74.7</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>15.1</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>8.6</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.0</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>110.0 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>25.0</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>3.2 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>74.7</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>15.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td>1.2</td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>8.6</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>138.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.0</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td><strong>110.0 H</strong></td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>25.0</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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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>12-JUL-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>0.7</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>0.9</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>2.8</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>6.3</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>331.1 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>12-JUL-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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              "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 and chloride, suggesting possible renal impairment or dehydration. Urinalysis reveals significant proteinuria, glucosuria, ketonuria, low specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal), indicating possible nephrotic syndrome or severe renal dysfunction. HbA1c is low, arguing against chronic hyperglycemia. No evidence of urinary infection. Recommend further renal evaluation and clinical correlation for underlying causes of proteinuria and renal impairment.</td></tr></table></div>"
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        "subject": {
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          "display": "Patricia Joubert"
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        "date": "2017-07-12T08:42:07Z",
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                "valueCodeableConcept": {
                  "coding": [
                    {
                      "code": "FR",
                      "system": "urn:iso:std:iso:3166"
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
          }
        ],
        "text": {
          "status": "generated",
          "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>"
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        "gender": "female",
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    {
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            "http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"
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        "identifier": [
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            "system": "http://example.org",
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        ],
        "specimen": [
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          {
            "reference": "urn:uuid:c509a0e2-26d4-4881-8a81-c53557195837"
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          {
            "reference": "urn:uuid:979fd049-171b-41c5-b6db-44b71e4cbc41"
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        ],
        "reasonCode": [
          {
            "coding": [
              {
                "code": "433144002",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 3"
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            ]
          },
          {
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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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              }
            ]
          },
          {
            "coding": [
              {
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                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
          },
          {
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                "display": "Alzheimer's disease"
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            ]
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                "system": "http://snomed.info/sct",
                "display": "Acute ST segment elevation myocardial infarction"
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            ]
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          {
            "coding": [
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                "system": "http://snomed.info/sct",
                "display": "Disorder of kidney due to diabetes mellitus"
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            ]
          },
          {
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              {
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                "system": "http://snomed.info/sct",
                "display": "Ischemic heart disease"
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            ]
          },
          {
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                "code": "431855005",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 1"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Chronic sinusitis"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Mitral valve stenosis"
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            ]
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          {
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              {
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                "system": "http://snomed.info/sct",
                "display": "Hyperlipidemia"
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            ]
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                "display": "Metabolic syndrome X"
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          {
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              {
                "code": "59621000",
                "system": "http://snomed.info/sct",
                "display": "Essential hypertension"
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            ]
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "active",
        "intent": "order",
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              "code": "108252007",
              "system": "http://snomed.info/sct",
              "display": "Laboratory procedure"
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        "subject": {
          "reference": "urn:uuid:a0424134-ada7-4f1f-9c0c-33f81f521233",
          "display": "Patricia Joubert"
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            "http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Role Id: 87f33668-f9ff-4b47-b413-423dff426895</div>"
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        "resourceType": "Organization",
        "id": "a83d6c56-7f22-41a0-b901-069ab1f1aeb8",
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          {
            "assigner": {
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Maison Médical</div>"
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        "name": "Maison Médical"
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      "fullUrl": "urn:uuid:9227ffd2-f9d1-42fd-92ac-d9f04153b081",
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        },
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        },
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              "display": "Acellular blood (serum or plasma) specimen"
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          ]
        },
        "collection": {
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        "text": {
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Urine specimen</td><td><span class=\"nb\">12-Jul-2017</span></td></tr></table></div>"
        },
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Whole blood specimen (specimen)</td><td><span class=\"nb\">12-Jul-2017</span></td></tr></table></div>"
        },
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              "code": "258580003",
              "system": "http://snomed.info/sct",
              "display": "Whole blood specimen (specimen)"
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    {
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              "code": "2345-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Serum or Plasma"
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          "text": "Glucose [Mass/volume] in Serum or Plasma"
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          "unit": "mg/dL",
          "code": "mg/dL"
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              "value": 140,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
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        "status": "final",
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          "display": "Patricia Joubert"
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        "effectiveDateTime": "2017-07-12T06:42:07Z",
        "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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          "value": 15.1,
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        "code": {
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              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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          ],
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          "value": 1.8,
          "unit": "mg/dL",
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        "text": {
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              "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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        "valueQuantity": {
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          "value": 8.6,
          "unit": "mg/dL",
          "code": "mg/dL"
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              "system": "http://unitsofmeasure.org"
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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>12-Jul-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>8.6</td><td>8.6 - 10.3</td><td></td><td>mg/dL</td></tr></table></div>"
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        "status": "final",
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          "display": "Patricia Joubert"
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        "effectiveDateTime": "2017-07-12T06:42:07Z",
        "specimen": {
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    {
      "fullUrl": "urn:uuid:bb0d0f70-1474-4694-bf4e-f36e41f4063e",
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        "code": {
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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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        "valueQuantity": {
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          "value": 138.9,
          "unit": "mmol/L",
          "code": "mmol/L"
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              "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>12-Jul-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.9</td><td>135 - 145</td><td></td><td>mmol/L</td></tr></table></div>"
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        "specimen": {
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      "fullUrl": "urn:uuid:e23b1228-42c8-4f7c-b49d-ba82e2793ccb",
      "resource": {
        "resourceType": "Observation",
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        "meta": {
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        "performer": [
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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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        "valueQuantity": {
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          "value": 4,
          "unit": "mmol/L",
          "code": "mmol/L"
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          "value": 2.8,
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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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              "display": "pH of Urine by Test strip"
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          ],
          "text": "pH of Urine by Test strip"
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        },
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      }
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      "fullUrl": "urn:uuid:02538b33-f5fb-4b49-8505-24f8bd6db285",
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        "code": {
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              "code": "5804-0",
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              "display": "Protein [Mass/volume] in Urine by Test strip"
            }
          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
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          "system": "http://unitsofmeasure.org",
          "value": 331.1,
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        "referenceRange": [
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            },
            "high": {
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        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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              "code": "20454-5",
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              "display": "Protein [Presence] in Urine by Test strip"
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
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        "text": {
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        },
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        "code": {
          "coding": [
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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"
        },
        "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>12-Jul-2017</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>"
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        "status": "final",
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        ],
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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": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>12-Jul-2017</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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        ],
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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"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>12-Jul-2017</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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          "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": 3.2,
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        ],
        "text": {
          "status": "generated",
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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"
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          ],
          "text": "Glucose [Mass/volume] in Blood"
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        "valueQuantity": {
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          "value": 74.7,
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            },
            "high": {
              "value": 140,
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              "system": "http://unitsofmeasure.org"
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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>12-Jul-2017</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>74.7</td><td>70 - 140</td><td></td><td>mg/dL</td></tr></table></div>"
        },
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            "text": "Interoperability Testing and Training (non-clinical use)"
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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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  "timestamp": "2017-07-12T08:42:07Z"
}