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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>28-SEP-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>79.4</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>11.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.3 H</strong></td><td>0.6 - 1.2</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>9.3</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.3</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><strong>108.5 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>27.6</td><td>22 - 32</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test negative</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>79.4</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>11.4</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>13.2 H</strong></td><td>0.6 - 1.2</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.3</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>138.3</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><strong>108.5 H</strong></td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>27.6</td><td>22 - 29</td><td>mmol/L</td></tr><tr><td>Cholesterol [Mass/volume] in Serum or Plasma</td><td>169.2</td><td>125 - 200</td><td>mg/dL</td></tr><tr><td>Triglyceride [Mass/volume] in Serum or Plasma</td><td>108.4</td><td>0 - 150</td><td>mg/dL</td></tr><tr><td>Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay</td><td>84.4</td><td>0 - 100</td><td>mg/dL</td></tr><tr><td>Cholesterol in HDL [Mass/volume] in Serum or Plasma</td><td><strong>63.2 H</strong></td><td>40 - 60</td><td>mg/dL</td></tr><tr><td>Microalbumin/Creatinine [Mass Ratio] in Urine</td><td><strong>349.9 H</strong></td><td>0 - 30</td><td>mg/g</td></tr></tbody></table></div>"
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                "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>28-SEP-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>2.5</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>0.5</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>17.8</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>6.2</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>418.1 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>"
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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>28-SEP-2023</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 creatinine and proteinuria, suggesting significant renal impairment, possibly nephrotic syndrome or advanced chronic kidney disease. Urine is abnormal (cloudy, brown, low specific gravity, high protein, ketones, glucose, bilirubin), supporting renal dysfunction. Electrolyte disturbances (high chloride), low HbA1c, and high microalbumin/creatinine ratio further support this. Immediate nephrology evaluation is recommended. No evidence of urinary tract infection.</td></tr></table></div>"
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              "code": "HTEST"
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            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
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          "tag": [
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              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
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          "profile": [
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              ]
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          {
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              ]
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            "system": "http://local.setting.eu/identifier",
            "value": "8e2c4509-b594-9ec4-42db-847eccf28678"
          }
        ],
        "name": [
          {
            "given": [
              "Tom"
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            "family": "Hayward",
            "text": "Tom Hayward"
          }
        ],
        "address": [
          {
            "line": [
              "391 Dean locks"
            ],
            "use": "home",
            "type": "physical",
            "postalCode": "M1",
            "city": "Manchester",
            "country": "United Kingdom"
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        ],
        "telecom": [
          {
            "system": "phone",
            "value": "+44(0)808 1570544"
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        ],
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            "extension": [
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                "url": "code",
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        "gender": "male",
        "birthDate": "1975-04-07"
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    },
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      "fullUrl": "urn:uuid:49856474-cb1e-49f8-80dd-a9838fdeb53a",
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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",
                "display": "Ischemic heart disease"
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            ]
          },
          {
            "coding": [
              {
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                "display": "Hyperlipidemia"
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            ]
          },
          {
            "coding": [
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                "display": "Chronic kidney disease stage 2"
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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",
                "display": "Chronic kidney disease stage 1"
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            ]
          },
          {
            "coding": [
              {
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                "system": "http://snomed.info/sct",
                "display": "Nonproliferative retinopathy due to type 2 diabetes mellitus"
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            ]
          },
          {
            "coding": [
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                "system": "http://snomed.info/sct",
                "display": "Retinopathy due to type 2 diabetes mellitus"
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            ]
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          {
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                "display": "Anemia"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Hyperglycemia"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Metabolic syndrome X"
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            ]
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          {
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                "system": "http://snomed.info/sct",
                "display": "Hypertriglyceridemia"
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            ]
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          {
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            ]
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          {
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              {
                "code": "59621000",
                "system": "http://snomed.info/sct",
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            ]
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        "intent": "order",
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              "system": "http://snomed.info/sct",
              "display": "Laboratory procedure"
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          ]
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        "subject": {
          "reference": "urn:uuid:71b05dd5-999e-432d-8164-c48e92213ce6",
          "display": "Tom Hayward"
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        "meta": {
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            "postalCode": "M3 3",
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        ],
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    {
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        },
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        "text": {
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        },
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    {
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        },
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              "display": "Whole blood specimen (specimen)"
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    {
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              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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        "category": [
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                "system": "http://terminology.hl7.org/CodeSystem/observation-category"
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        ],
        "performer": [
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        "code": {
          "coding": [
            {
              "code": "17861-6",
              "system": "http://loinc.org",
              "display": "Calcium [Mass/volume] in Serum or Plasma"
            }
          ],
          "text": "Calcium [Mass/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 9.3,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
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              "value": 8.5,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 10.5,
              "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>28-Sep-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>9.3</td><td>8.5 - 10.5</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Tom Hayward"
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        "effectiveDateTime": "2023-09-28T06:17:44Z",
        "specimen": {
          "reference": "urn:uuid:6190b0ed-9593-4602-8f89-a537cf5a15ca"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:3616c22d-c5e3-49d2-a1bf-b859aa1b11c8",
      "resource": {
        "resourceType": "Observation",
        "id": "3616c22d-c5e3-49d2-a1bf-b859aa1b11c8",
        "meta": {
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        },
        "category": [
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                "code": "laboratory",
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          }
        ],
        "performer": [
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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"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 138.3,
          "unit": "mmol/L",
          "code": "mmol/L"
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        "code": {
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            {
              "code": "5770-3",
              "system": "http://loinc.org",
              "display": "Bilirubin.total [Presence] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Presence] in Urine by Test strip"
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        ],
        "code": {
          "coding": [
            {
              "code": "5797-6",
              "system": "http://loinc.org",
              "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": {
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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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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>28-Sep-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test negative</td></tr></table></div>"
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              "display": "Urine ketone test negative"
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        ],
        "code": {
          "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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          "coding": [
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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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        "category": [
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        "code": {
          "coding": [
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              "code": "5804-0",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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          "value": 418.1,
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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>Test</th><th>28-Sep-2023</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>418.1</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
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              "code": "20454-5",
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
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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"
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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"
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              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
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          ],
          "text": "Leukocyte esterase [Presence] in Urine by Test strip"
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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>Test</th><th>28-Sep-2023</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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              "code": "4548-4",
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              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
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          "value": 3.3,
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        ],
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          "text": "Glucose [Mass/volume] in Blood"
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        "valueQuantity": {
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          "text": "Calcium [Mass/volume] in Blood"
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              "display": "Sodium [Moles/volume] in Blood"
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              "display": "Chloride [Moles/volume] in Blood"
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          ],
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        "valueQuantity": {
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          "value": 108.5,
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        ],
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              "display": "Triglyceride [Mass/volume] in Serum or Plasma"
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          ],
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              "display": "Microalbumin/Creatinine [Mass Ratio] in Urine"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">SYNDERAI Synthetic Generator v5.0</div>"
        },
        "status": "active",
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              "display": "create"
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          ],
          "text": "Synthetic Example Data Generation"
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                "display": "training"
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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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        "recorded": "2023-09-28T08:17:44Z"
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: bd6a514e-817c-4c9a-a6a0-c6498da28217</div>"
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            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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  "type": "document",
  "timestamp": "2023-09-28T08:17:44Z"
}