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                    "reference": "urn:uuid:7f13c6a6-6195-4556-95d3-43ad1ee1efa3"
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                    "reference": "urn:uuid:ac30dd7b-d46a-4407-aa03-6cb9c4a7ccba"
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                  {
                    "reference": "urn:uuid:ebdc2245-bcf8-4a2e-bb03-f10534e5753f"
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                    "reference": "urn:uuid:de18eeca-b7ed-4d3f-a2a8-e67e645477f6"
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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>08-JUN-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>97.0</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>7.5</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.1 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>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>141.1</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.0</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td><strong>109.3 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><strong>20.6 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>3.1 L</strong></td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>97.0</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>7.5</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>1.5 H</strong></td><td>0.7 - 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>141.1</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><strong>109.3 H</strong></td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td><strong>20.6 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>08-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><strong>1.1 H</strong></td><td>0 - 0.8</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>1.5 H</strong></td><td>0.0 - 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>5.6 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>6.8</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>333.6 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>"
                },
                "title": "Urinalysis"
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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>08-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 elevated creatinine, proteinuria, glucosuria, ketonuria, and bilirubinuria, with low urine specific gravity and metabolic acidosis (low CO₂, high chloride). These findings suggest impaired renal function, likely chronic kidney disease with possible nephrotic-range proteinuria. The abnormal urine appearance and color may indicate underlying urinary tract or hepatic pathology. HbA1c is unexpectedly low despite glucosuria; consider possible analytical error or altered red cell turnover. Clinical correlation and further nephrological and metabolic evaluation are recommended.</td></tr></table></div>"
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          "reference": "urn:uuid:a8591f60-4a12-460a-8fc7-53e6c841bb0d",
          "display": "Yves Rémy"
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        "date": "2025-06-08T07:32:03Z",
        "title": "Laboratory Report",
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            "postalCode": "06400",
            "city": "Cannes",
            "country": "France"
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        ],
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                  ]
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              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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              "value": 145,
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              "system": "http://loinc.org",
              "display": "Potassium [Moles/volume] in Serum or Plasma"
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.0</td><td>3.5 - 5.1</td><td></td><td>mmol/L</td></tr></table></div>"
        },
        "status": "final",
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        "resourceType": "Observation",
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        ],
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        ],
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            {
              "code": "2075-0",
              "system": "http://loinc.org",
              "display": "Chloride [Moles/volume] in Serum or Plasma"
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          ],
          "text": "Chloride [Moles/volume] in Serum or Plasma"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 109.3,
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        ],
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            ]
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        ],
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        ],
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            {
              "code": "2028-9",
              "system": "http://loinc.org",
              "display": "Carbon dioxide, total [Moles/volume] in Serum or Plasma"
            }
          ],
          "text": "Carbon dioxide, total [Moles/volume] in Serum or Plasma"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 20.6,
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        },
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        "specimen": {
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        "code": {
          "coding": [
            {
              "code": "5767-9",
              "system": "http://loinc.org",
              "display": "Appearance of Urine"
            }
          ],
          "text": "Appearance of Urine"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Appearance of Urine</td><td>Cloudy urine</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
          "reference": "urn:uuid:a8591f60-4a12-460a-8fc7-53e6c841bb0d",
          "display": "Yves Rémy"
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        "effectiveDateTime": "2025-06-08T05:32:03Z",
        "valueCodeableConcept": {
          "coding": [
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              "code": "7766007",
              "system": "http://snomed.info/sct",
              "display": "Cloudy urine"
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        "category": [
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                "code": "laboratory",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "34533-0",
              "system": "http://loinc.org",
              "display": "Odor of Urine"
            }
          ],
          "text": "Odor of Urine"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Odor of Urine</td><td>Urine smell ammoniacal</td></tr></table></div>"
        },
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "32167-9",
              "system": "http://loinc.org",
              "display": "Clarity of Urine"
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          ],
          "text": "Clarity of Urine"
        },
        "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>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Clarity of Urine</td><td>Translucent</td></tr></table></div>"
        },
        "status": "final",
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        "valueCodeableConcept": {
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              "display": "Translucent"
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        "code": {
          "coding": [
            {
              "code": "5778-6",
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              "display": "Color of Urine"
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          ],
          "text": "Color of Urine"
        },
        "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>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Color of Urine</td><td>Brown color</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Yves Rémy"
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        "effectiveDateTime": "2025-06-08T05:32:03Z",
        "valueCodeableConcept": {
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              "code": "371254008",
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              "display": "Brown color"
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        },
        "specimen": {
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        "meta": {
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        },
        "category": [
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        "code": {
          "coding": [
            {
              "code": "5792-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Glucose [Mass/volume] in Urine by Test strip"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 1.1,
          "unit": "mg/dL",
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        "referenceRange": [
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            "low": {
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            "high": {
              "value": 0.8,
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              "system": "http://unitsofmeasure.org"
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                "display": "High"
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            ]
          }
        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "category": [
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        "code": {
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              "code": "25428-4",
              "system": "http://loinc.org",
              "display": "Glucose [Presence] in Urine by Test strip"
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          ],
          "text": "Glucose [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>08-Jun-2025</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>Urine glucose test = ++</td></tr></table></div>"
        },
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        "effectiveDateTime": "2025-06-08T05:32:03Z",
        "valueCodeableConcept": {
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        "category": [
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        "code": {
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              "code": "20505-4",
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              "display": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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          ],
          "text": "Bilirubin.total [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
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          "value": 1.5,
          "unit": "mg/dL",
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            ]
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        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "category": [
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            {
              "code": "5770-3",
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              "display": "Bilirubin.total [Presence] in Urine by Test strip"
            }
          ],
          "text": "Bilirubin.total [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
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              "code": "5803-2",
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              "code": "5804-0",
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              "display": "Protein [Mass/volume] in Urine by Test strip"
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          "value": 333.6,
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              "display": "Nitrite [Presence] in Urine by Test strip"
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              "display": "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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              "code": "4548-4",
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              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
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          ],
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            ],
            "given": [
              "Ex"
            ],
            "family": "Ample"
          }
        ],
        "address": [
          {
            "line": [
              "Laboratoire Central Européenne",
              "Boulevard du Jardin Botanique 32"
            ],
            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory: Laboratoire Central Européenne, 1000 Brussels, Belgium</div>"
        }
      }
    }
  ],
  "type": "document",
  "timestamp": "2025-06-08T07:32:03Z"
}