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                    "reference": "urn:uuid:e2acbdc1-41ed-413e-a715-e80fd317b453"
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                  {
                    "reference": "urn:uuid:885a00ae-023c-4841-9216-b63269b2cb6a"
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                  {
                    "reference": "urn:uuid:0372058a-c2d7-480e-9087-f8b6a90ca6f4"
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                    "reference": "urn:uuid:db6fc07e-6534-4ed3-b355-e8601c797850"
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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>26-FEB-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>85.5</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>17.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.0 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>9.9</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>136.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>5.1</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>104.1</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>24.2</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>3.3 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>85.5</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>17.1</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</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 Blood</td><td>9.9</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>136.9</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>5.1</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>104.1</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>24.2</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
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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>26-FEB-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>1.3</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>5.2 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>5.6</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>271.9 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>26-FEB-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, suggesting impaired renal function. Urinalysis reveals significant proteinuria, ketonuria, glucosuria, low specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal), indicating possible nephrotic syndrome or diabetic nephropathy, though HbA1c is low. No evidence of urinary infection. Recommend further renal evaluation and assessment for underlying metabolic or systemic disease.</td></tr></table></div>"
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        "date": "2025-02-26T07:42:07Z",
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
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        "gender": "female",
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      "fullUrl": "urn:uuid:c435fd95-460f-42c3-91f5-c13d04b523fa",
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          {
            "reference": "urn:uuid:f7a1b4a1-5f41-443b-9366-099b639371ff"
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          {
            "reference": "urn:uuid:da324473-189c-4bec-a8db-ebb1c5cac6f8"
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        ],
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            ]
          },
          {
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              {
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            ]
          },
          {
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            ]
          },
          {
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            ]
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          {
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          {
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                "system": "http://snomed.info/sct",
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            ]
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          {
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                "display": "Ischemic heart disease"
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          {
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                "display": "Chronic kidney disease stage 1"
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          {
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                "display": "Chronic sinusitis"
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                "display": "Mitral valve stenosis"
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                "display": "Hyperlipidemia"
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              "code": "2345-7",
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              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "value": 140,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "display": "Calcium [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 9.9,
          "unit": "mg/dL",
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              "code": "mg/dL",
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        "specimen": {
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              "code": "2951-2",
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              "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": 136.9,
          "unit": "mmol/L",
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              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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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": 5.1,
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        ],
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        },
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            {
              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
            }
          ],
          "text": "Ketones [Presence] in Urine by Test strip"
        },
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        },
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          "coding": [
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              "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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          "value": 1,
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              "value": 1.03,
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              "system": "http://unitsofmeasure.org",
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            ]
          }
        ],
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          "status": "generated",
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          "coding": [
            {
              "code": "5803-2",
              "system": "http://loinc.org",
              "display": "pH of Urine by Test strip"
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          ],
          "text": "pH of Urine by Test strip"
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        "valueQuantity": {
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          "value": 5.6,
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            "high": {
              "value": 8,
              "code": "pH",
              "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>26-Feb-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>5.6</td><td>5.0 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:72768423-552f-4df8-93e7-d5c556ffcb45",
          "display": "Patricia Joubert"
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        "effectiveDateTime": "2025-02-26T06:42:07Z",
        "specimen": {
          "reference": "urn:uuid:f7a1b4a1-5f41-443b-9366-099b639371ff"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:b13a7df6-f1c9-44a7-ad77-24b71e43c9ec",
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        "resourceType": "Observation",
        "id": "b13a7df6-f1c9-44a7-ad77-24b71e43c9ec",
        "meta": {
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        },
        "category": [
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                "code": "laboratory",
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        ],
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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": 271.9,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
          {
            "low": {
              "value": 0,
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
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                "display": "High"
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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>26-Feb-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>271.9</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "code": {
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              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
        },
        "text": {
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        },
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        "code": {
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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>26-Feb-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",
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        "code": {
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              "code": "5794-3",
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              "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>26-Feb-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>"
        },
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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>26-Feb-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>"
        },
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          "display": "Patricia Joubert"
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        "effectiveDateTime": "2025-02-26T06:42:07Z",
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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": 3.3,
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              "value": 5.6,
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            ]
          }
        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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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": 85.5,
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        "referenceRange": [
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            },
            "high": {
              "value": 140,
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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>26-Feb-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>85.5</td><td>70 - 140</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Patricia Joubert"
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}