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                    "reference": "urn:uuid:fdf2cee3-fced-4e6b-be72-c657ec538b63"
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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>03-JUN-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Blood</td><td>87.3</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>11.9</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>3.1 H</strong></td><td>0.6 - 1.2</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.6</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>137.5</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>106.0</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>28.6</td><td>22 - 29</td><td>mmol/L</td></tr><tr><td>Protein [Mass/volume] in Serum or Plasma</td><td>6.9</td><td>6.0 - 8.3</td><td>g/dL</td></tr><tr><td>Albumin [Mass/volume] in Serum or Plasma</td><td>3.9</td><td>3.5 - 5.5</td><td>g/dL</td></tr><tr><td>Globulin [Mass/volume] in Serum by calculation</td><td><strong>2.0 L</strong></td><td>20 - 39</td><td>g/L</td></tr><tr><td>Bilirubin.total [Mass/volume] in Serum or Plasma</td><td>1.0</td><td>0.3 - 1.2</td><td>mg/dL</td></tr><tr><td>Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma</td><td><strong>36.8 L</strong></td><td>39 - 117</td><td>U/L</td></tr><tr><td>Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma</td><td>25.4</td><td>10 - 40</td><td>U/L</td></tr><tr><td>Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma</td><td>15.7</td><td>10 - 40</td><td>U/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test negative</td><td></td><td></td></tr></tbody></table></div>"
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                  "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>03-JUN-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>2.1</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><strong>1.3 H</strong></td><td>0 - 1</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>19.3</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>6.9</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>399.6 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>"
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                  "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>03-JUN-2025</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 markedly elevated serum creatinine, significant proteinuria, glucosuria, ketonuria, and bilirubinuria, with low urine specific gravity and abnormal urine appearance (cloudy, brown, ammoniacal). These findings suggest impaired renal function, likely acute or chronic kidney injury, with possible tubular dysfunction. Liver function appears preserved. Immediate nephrology evaluation is recommended for further assessment and management.</td></tr></table></div>"
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            "city": "Manchester",
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Tom Hayward</td><td>male</td><td>07-Apr-1975</td></tr></table></div>"
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              "display": "Urea nitrogen [Mass/volume] in Blood"
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              "display": "Calcium [Mass/volume] in Blood"
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              "display": "Sodium [Moles/volume] in Blood"
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          "value": 137.5,
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        "code": {
          "coding": [
            {
              "code": "6298-4",
              "system": "http://loinc.org",
              "display": "Potassium [Moles/volume] in Blood"
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          ],
          "text": "Potassium [Moles/volume] in Blood"
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        "valueQuantity": {
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          "value": 4,
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            {
              "code": "2069-3",
              "system": "http://loinc.org",
              "display": "Chloride [Moles/volume] in Blood"
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          ],
          "text": "Chloride [Moles/volume] in Blood"
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          "value": 106,
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              "value": 107,
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        "category": [
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        "code": {
          "coding": [
            {
              "code": "20565-8",
              "system": "http://loinc.org",
              "display": "Carbon dioxide, total [Moles/volume] in Blood"
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          ],
          "text": "Carbon dioxide, total [Moles/volume] in Blood"
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          "system": "http://unitsofmeasure.org",
          "value": 28.6,
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              "value": 29,
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        },
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        "specimen": {
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              "code": "2885-2",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Protein [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 6.9,
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        "code": {
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            {
              "code": "1751-7",
              "system": "http://loinc.org",
              "display": "Albumin [Mass/volume] in Serum or Plasma"
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          "value": 3.9,
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        },
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        "specimen": {
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        "code": {
          "coding": [
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              "code": "10834-0",
              "system": "http://loinc.org",
              "display": "Globulin [Mass/volume] in Serum by calculation"
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          ],
          "text": "Globulin [Mass/volume] in Serum by calculation"
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        "valueQuantity": {
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          "value": 2,
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              "code": "g/L",
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            "high": {
              "value": 39,
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                "display": "Low"
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            ]
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        ],
        "text": {
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        "specimen": {
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    {
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        "category": [
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                "code": "laboratory",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "1975-2",
              "system": "http://loinc.org",
              "display": "Bilirubin.total [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Bilirubin.total [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 1,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
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            "low": {
              "value": 0.3,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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            "high": {
              "value": 1.2,
              "code": "mg/dL",
              "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>03-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Bilirubin.total [Mass/volume] in Serum or Plasma</td><td>1.0</td><td>0.3 - 1.2</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Tom Hayward"
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        "effectiveDateTime": "2025-06-03T21:33:44Z",
        "specimen": {
          "reference": "urn:uuid:6f3ea37b-41ba-4fce-bfe8-b878a28af6a9"
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    {
      "fullUrl": "urn:uuid:e712768a-f80a-4298-8853-8009723eddc6",
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        "category": [
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                "code": "laboratory",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "6768-6",
              "system": "http://loinc.org",
              "display": "Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma"
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          ],
          "text": "Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 36.8,
          "unit": "U/L",
          "code": "U/L"
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        "referenceRange": [
          {
            "low": {
              "value": 39,
              "code": "U/L",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 117,
              "code": "U/L",
              "system": "http://unitsofmeasure.org"
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        ],
        "interpretation": [
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            "coding": [
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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>03-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma</td><td>36.8</td><td>39 - 117</td><td>L</td><td>U/L</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Tom Hayward"
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        "specimen": {
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    {
      "fullUrl": "urn:uuid:5ee8d331-5070-416e-864a-dd7af42dbfb3",
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        },
        "category": [
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            "coding": [
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                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
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            ]
          }
        ],
        "performer": [
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        ],
        "code": {
          "coding": [
            {
              "code": "1742-6",
              "system": "http://loinc.org",
              "display": "Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma"
            }
          ],
          "text": "Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 25.4,
          "unit": "U/L",
          "code": "U/L"
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        "referenceRange": [
          {
            "low": {
              "value": 10,
              "code": "U/L",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 40,
              "code": "U/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>03-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma</td><td>25.4</td><td>10 - 40</td><td></td><td>U/L</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:aadb480b-dfb9-4121-8011-faad85e4b11d",
          "display": "Tom Hayward"
        },
        "effectiveDateTime": "2025-06-03T21:33:44Z",
        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:fdf2cee3-fced-4e6b-be72-c657ec538b63",
      "resource": {
        "resourceType": "Observation",
        "id": "fdf2cee3-fced-4e6b-be72-c657ec538b63",
        "meta": {
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        },
        "category": [
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            "coding": [
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                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
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            ]
          }
        ],
        "performer": [
          {
            "display": "The Central European Lab"
          }
        ],
        "code": {
          "coding": [
            {
              "code": "1920-8",
              "system": "http://loinc.org",
              "display": "Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma"
            }
          ],
          "text": "Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 15.7,
          "unit": "U/L",
          "code": "U/L"
        },
        "referenceRange": [
          {
            "low": {
              "value": 10,
              "code": "U/L",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 40,
              "code": "U/L",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
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              "code": "5802-4",
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          "text": "Nitrite [Presence] in Urine by Test strip"
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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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              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">SYNDERAI Synthetic Generator v5.0</div>"
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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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            "postalCode": "1000",
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}