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                "code": {
                  "coding": [
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                      "display": "Chemistry studies (set)"
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                "entry": [
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                    "reference": "urn:uuid:58af940c-d686-4f98-8b92-a8edffa9c480"
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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>12-OCT-2016</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>89.8</td><td>70 - 140</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>16.3</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</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 Serum or Plasma</td><td>9.2</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.7</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.9</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>28.6</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>3.1 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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              {
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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>12-OCT-2016</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>1.4</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>12.0 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>6.9</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>224.5 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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                "entry": [
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                  "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>12-OCT-2016</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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              "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 elevated serum creatinine, suggesting impaired renal function. Urinalysis reveals proteinuria, glucosuria, ketonuria, low specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal), indicating possible renal pathology (e.g., nephrotic syndrome, diabetic nephropathy) or acute illness. Blood glucose and HbA1c are not elevated, making diabetes less likely. No evidence of urinary infection. Recommend further renal evaluation and clinical correlation.</td></tr></table></div>"
            },
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          "status": "empty",
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:e1599e91-041a-4714-985e-9a69b5b24d32",
          "display": "Patricia Joubert"
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        "date": "2016-10-12T08:42:07Z",
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        "subject": {
          "reference": "urn:uuid:e1599e91-041a-4714-985e-9a69b5b24d32",
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              "code": "TRAIN"
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              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
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        "identifier": [
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            "value": "7843-162355-8"
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        ],
        "name": [
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            "family": "Joubert",
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        ],
        "address": [
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            "use": "home",
            "type": "physical",
            "postalCode": "50570",
            "city": "Delahaye-la-Forêt",
            "country": "France"
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        ],
        "telecom": [
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            "system": "phone",
            "value": "0760047035"
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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>Patricia Joubert</td><td>female</td><td>10-Sep-1939</td></tr></table></div>"
        },
        "gender": "female",
        "birthDate": "1939-09-10"
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        ],
        "reasonCode": [
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            "coding": [
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                "code": "433144002",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 3"
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            ]
          },
          {
            "coding": [
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                "display": "Proteinuria due to type 2 diabetes mellitus"
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          {
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                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 2"
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            ]
          },
          {
            "coding": [
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                "system": "http://snomed.info/sct",
                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
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          {
            "coding": [
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            ]
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                "display": "Acute ST segment elevation myocardial infarction"
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                "display": "training"
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            "text": "Interoperability Testing and Training (non-clinical use)"
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}