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                  "code": "26436-6",
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                  "display": "Laboratory studies (set)"
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                  "coding": [
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                      "code": "18719-5",
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                      "display": "Chemistry studies (set)"
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                  ],
                  "text": "Chemistry"
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                "entry": [
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                    "reference": "urn:uuid:eaa7a271-9598-4bf8-b83d-1136d9d73bf0"
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                    "reference": "urn:uuid:90ee2488-8de9-4747-9118-94398f140ab5"
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                    "reference": "urn:uuid:022e602f-e1d1-47eb-8184-3822a1d9b2ff"
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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>01-DEC-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td><strong>68.1 L</strong></td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>9.6</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>9.2</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>142.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>5.0</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>101.5</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>23.5</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>2.8 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
                  "coding": [
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                      "code": "18729-4",
                      "system": "http://loinc.org",
                      "display": "Urinalysis studies (set)"
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                  "text": "Urinalysis"
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                    "reference": "urn:uuid:dab971ea-ac1f-4908-97d8-4a6c60149942"
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                  {
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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>01-DEC-2024</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>1.8 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>0.5 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>9.6 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>5.1</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>198.4 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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                      "system": "http://loinc.org",
                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:6e4e3dd3-f5f1-4f0d-abf2-c3bd5c386b5c"
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                    "reference": "urn:uuid:1cc1b0cf-b82a-4923-8c8a-5d333174f1f9"
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                "text": {
                  "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>01-DEC-2024</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>"
                },
                "title": "Specimen information"
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            ],
            "title": "Laboratory Report"
          },
          {
            "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 mild hypoglycemia, elevated creatinine suggesting impaired renal function, and significant proteinuria, glycosuria, ketonuria, and bilirubinuria, with low urine specific gravity. HbA1c is unexpectedly low, possibly due to anemia or recent blood loss/hemolysis. Urine findings (cloudy, brown, ammoniacal) may indicate underlying renal or hepatic pathology. Recommend further evaluation for acute or chronic kidney disease, possible hepatic dysfunction, and assessment for causes of low HbA1c.</td></tr></table></div>"
            },
            "code": {
              "coding": [
                {
                  "code": "48767-8",
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                  "display": "Annotation comment [Interpretation] Narrative"
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            "title": "Annotation comment"
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        "text": {
          "status": "empty",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:9dacb390-2153-4d31-a0dc-1cfde50bfa4c",
          "display": "Yves Rémy"
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        "date": "2024-12-01T06:32:03Z",
        "title": "Laboratory Report",
        "confidentiality": "N"
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        "text": {
          "status": "empty",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "registered",
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              "code": "11502-2",
              "system": "http://loinc.org",
              "display": "Laboratory report"
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        "subject": {
          "reference": "urn:uuid:9dacb390-2153-4d31-a0dc-1cfde50bfa4c",
          "display": "Yves Rémy"
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        "id": "9dacb390-2153-4d31-a0dc-1cfde50bfa4c",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
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              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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          ],
          "tag": [
            {
              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
            }
          ],
          "profile": [
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        },
        "identifier": [
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            "type": {
              "coding": [
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                  "code": "JHN",
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            "system": "http://ec.europa.eu/identifier/eci",
            "value": "4543-821530-8"
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          {
            "type": {
              "coding": [
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                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
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              ]
            },
            "system": "http://local.setting.eu/identifier",
            "value": "12ef67e4-2698-90f4-7860-a5366805885f"
          }
        ],
        "name": [
          {
            "given": [
              "Yves"
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            "family": "Rémy",
            "text": "Yves Rémy"
          }
        ],
        "address": [
          {
            "line": [
              "rue de Turpin"
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            "use": "home",
            "type": "physical",
            "postalCode": "06400",
            "city": "Cannes",
            "country": "France"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "+33 (0)1 53 38 28 55"
          }
        ],
        "extension": [
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            "extension": [
              {
                "url": "code",
                "valueCodeableConcept": {
                  "coding": [
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                      "system": "urn:iso:std:iso:3166"
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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>Yves Rémy</td><td>male</td><td>16-May-1948</td></tr></table></div>"
        },
        "gender": "male",
        "birthDate": "1948-05-16"
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    },
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          {
            "reference": "urn:uuid:56338c68-4260-4924-a30d-56fce62e9d92"
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        ],
        "reasonCode": [
          {
            "coding": [
              {
                "code": "88805009",
                "system": "http://snomed.info/sct",
                "display": "Chronic congestive heart failure"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "431856006",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 2"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "90781000119102",
                "system": "http://snomed.info/sct",
                "display": "Microalbuminuria due to type 2 diabetes mellitus"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "127013003",
                "system": "http://snomed.info/sct",
                "display": "Disorder of kidney due to diabetes mellitus"
              }
            ]
          },
          {
            "coding": [
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                "code": "431855005",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 1"
              }
            ]
          },
          {
            "coding": [
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                "code": "414545008",
                "system": "http://snomed.info/sct",
                "display": "Ischemic heart disease"
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            ]
          },
          {
            "coding": [
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                "code": "64859006",
                "system": "http://snomed.info/sct",
                "display": "Osteoporosis"
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              "display": "Chloride [Moles/volume] in Serum or Plasma"
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          ],
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          ],
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              "code": "25428-4",
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        "code": {
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              "code": "20505-4",
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          ],
          "text": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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          "value": 0.5,
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        ],
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        ],
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              "display": "Bilirubin.total [Presence] in Urine by Test strip"
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        ],
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        "code": {
          "coding": [
            {
              "code": "5797-6",
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              "display": "Ketones [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Ketones [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 9.6,
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            "high": {
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            ]
          }
        ],
        "text": {
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        "code": {
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              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
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          ],
          "text": "Ketones [Presence] in Urine by Test strip"
        },
        "text": {
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          "text": "Hemoglobin [Presence] in Urine by Test strip"
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              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
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                "display": "training"
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            "text": "Interoperability Testing and Training (non-clinical use)"
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              "dr"
            ],
            "given": [
              "Ex"
            ],
            "family": "Ample"
          }
        ],
        "address": [
          {
            "line": [
              "Laboratoire Central Européenne",
              "Boulevard du Jardin Botanique 32"
            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
        }
      }
    }
  ],
  "type": "document",
  "timestamp": "2024-12-01T06:32:03Z"
}