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                    "reference": "urn:uuid:ba701980-2f69-4525-a1f8-b72bbdca7d15"
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                  {
                    "reference": "urn:uuid:9f78f370-b484-429f-bf06-e5701cea7e12"
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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>30-APR-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>89.5</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>9.8</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>1.9 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>10.0</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>143.6</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>106.8</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td><strong>21.8 L</strong></td><td>22 - 29</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = ++</td><td></td><td></td></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td><strong>2.9 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>89.5</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>9.8</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>2.7 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>10.0</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>143.6</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.8</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>106.8</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td><strong>21.8 L</strong></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>30-APR-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>1.6</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>0.3</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><strong>13.8 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>6.3</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>299.4 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>"
                },
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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>30-APR-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 elevated creatinine, low total CO₂, and significant proteinuria, suggesting impaired renal function with possible metabolic acidosis. Urine findings (cloudy, brown, low specific gravity, protein, glucose, ketones) indicate renal involvement, possibly nephrotic syndrome or acute kidney injury. No evidence of urinary tract infection. Low HbA1c with normoglycemia may reflect anemia or recent changes in glycemic control. Recommend nephrology evaluation and further assessment of renal and metabolic status.</td></tr></table></div>"
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        "date": "2025-04-30T08:42:07Z",
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            "use": "home",
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            "city": "Delahaye-la-Forêt",
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                      "code": "FR",
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
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            "reference": "urn:uuid:1c891cf4-793c-4c7e-b48d-5334b19a7174"
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            ]
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          {
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              "code": "mg/dL",
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              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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          "unit": "mg/dL",
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              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          "value": 143.6,
          "unit": "mmol/L",
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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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              "value": 5.1,
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              "code": "2075-0",
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              "display": "Chloride [Moles/volume] in Serum or Plasma"
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          ],
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          ],
          "text": "Appearance of Urine"
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          ],
          "text": "Clarity of Urine"
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          ],
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          ],
          "text": "Ketones [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 13.8,
          "unit": "mg/dL",
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        "referenceRange": [
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              "value": 0,
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            },
            "high": {
              "value": 4,
              "code": "mg/dL",
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        "interpretation": [
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                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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            ]
          }
        ],
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          "status": "generated",
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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>30-Apr-2025</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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              "display": "Urine ketone test = ++"
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        "code": {
          "coding": [
            {
              "code": "5811-5",
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              "display": "Specific gravity of Urine by Test strip"
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          ],
          "text": "Specific gravity of Urine by Test strip"
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        "valueQuantity": {
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          "value": 1,
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              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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              "value": 1.03,
              "code": "1",
              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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                "code": "L",
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                "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>30-Apr-2025</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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    {
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        },
        "category": [
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                "code": "laboratory",
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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": 6.3,
          "unit": "pH",
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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>30-Apr-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>6.3</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:d4cc1d0f-4de4-434e-967e-073383104bfa",
          "display": "Patricia Joubert"
        },
        "effectiveDateTime": "2025-04-30T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:9f4c14d4-240e-4cfd-998b-b59802cd42c3"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:1d3feb26-82ff-4c46-9ea4-016caa1352f9",
      "resource": {
        "resourceType": "Observation",
        "id": "1d3feb26-82ff-4c46-9ea4-016caa1352f9",
        "meta": {
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        },
        "category": [
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            "coding": [
              {
                "code": "laboratory",
                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
              }
            ]
          }
        ],
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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": 299.4,
          "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"
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        ],
        "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>30-Apr-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>299.4</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2025-04-30T06:42:07Z",
        "specimen": {
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    {
      "fullUrl": "urn:uuid:3b5172ab-139d-4ceb-b032-ee45af29efd9",
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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>30-Apr-2025</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": "2025-04-30T06:42:07Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = ++"
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        ],
        "code": {
          "coding": [
            {
              "code": "5802-4",
              "system": "http://loinc.org",
              "display": "Nitrite [Presence] in Urine by Test strip"
            }
          ],
          "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>30-Apr-2025</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",
        "subject": {
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        "valueCodeableConcept": {
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              "display": "Urine nitrite negative"
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        ],
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        ],
        "code": {
          "coding": [
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              "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>30-Apr-2025</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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        "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>30-Apr-2025</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>"
        },
        "status": "final",
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          "display": "Patricia Joubert"
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        "effectiveDateTime": "2025-04-30T06:42:07Z",
        "valueCodeableConcept": {
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              "display": "Urine leukocyte test negative"
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    },
    {
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
            }
          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
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        "valueQuantity": {
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          "value": 2.9,
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            ]
          }
        ],
        "text": {
          "status": "generated",
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        },
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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": 89.5,
          "unit": "mg/dL",
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        "referenceRange": [
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            },
            "high": {
              "value": 140,
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              "system": "http://unitsofmeasure.org"
            }
          }
        ],
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            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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        ],
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}