{
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                  "coding": [
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                      "system": "http://loinc.org",
                      "display": "Chemistry studies (set)"
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                    "reference": "urn:uuid:e2cd063b-59b2-4002-9df0-2a777eb8544b"
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                  {
                    "reference": "urn:uuid:fdb7dd43-23cd-4d5a-9c20-256814602d73"
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                  {
                    "reference": "urn:uuid:dc9374ce-15f5-450f-9203-6a605655b4c8"
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                  {
                    "reference": "urn:uuid:baa30f65-14e8-45ed-a335-fecefcc6660a"
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                  {
                    "reference": "urn:uuid:fa5ab39e-3592-4254-9579-7419ff6f51c4"
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                  {
                    "reference": "urn:uuid:c49a40a8-16fe-48b9-8dd0-02200279259d"
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                  {
                    "reference": "urn:uuid:39ff5ba4-2733-4d7c-8dca-625293f99b3e"
                  },
                  {
                    "reference": "urn:uuid:e4233d04-1030-418e-8818-4c2a4e895d63"
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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>20-AUG-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>97.5</td><td>70 - 99</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>19.0</td><td>7 - 50</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 - 1.1</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>9.0</td><td>8.6 - 10.4</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>138.5</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>102.1</td><td>98 - 108</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>28.0</td><td>22 - 32</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>4.0</td><td>4 - 6.4</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>97.5</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>19.0</td><td>7 - 43</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>3.7 H</strong></td><td>0.6 - 1.1</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.0</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>138.5</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>102.1</td><td>98 - 108</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>28.0</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
                  "coding": [
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                      "code": "$18729-4",
                      "system": "http://loinc.org",
                      "display": "Urinalysis studies (set)"
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                  "text": "Urinalysis"
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                "entry": [
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                    "reference": "urn:uuid:5c8ad68c-31ea-4c17-bc94-0acf6767091c"
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                    "reference": "urn:uuid:ef45d349-d05e-422c-9af1-5eb4bc758b31"
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                    "reference": "urn:uuid:e012f356-c227-4abe-aa06-cec4cd836630"
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                    "reference": "urn:uuid:b8128fc8-1a69-4d14-b264-20b8c6a835cb"
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                "text": {
                  "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>20-AUG-2024</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>1.6 H</strong></td><td>0.8 - 0</td><td>mg/dL</td></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>++</td><td></td><td></td></tr><tr><td>Bilirubin.total [Mass/volume] in Urine by Test strip</td><td>0.7</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><strong>8.8 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 - 1.03</td><td>{nominal}</td></tr><tr><td>pH of Urine by Test strip</td><td>5.7</td><td>4.6 - 7</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>365.0 H</strong></td><td>0 - 14</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"
              },
              {
                "code": {
                  "coding": [
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                      "code": "$LP7846-1",
                      "system": "http://loinc.org",
                      "display": "Specimen information"
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                  "text": "Specimen information"
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                "entry": [
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                    "reference": "urn:uuid:fa1496a9-dfef-47e6-a57f-43a66ed9ac3b"
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                "text": {
                  "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>20-AUG-2024</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>"
                },
                "title": "Specimen information"
              }
            ],
            "title": "Laboratory Report"
          },
          {
            "text": {
              "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 significantly elevated creatinine in both serum and blood, indicating impaired renal function. Urinalysis reveals marked proteinuria, glucosuria, ketonuria, low specific gravity, and abnormal urine appearance (cloudy, brown, ammoniacal), suggesting possible nephrotic syndrome or acute kidney injury with metabolic derangements. Blood glucose and HbA1c are normal, making diabetes less likely. Recommend urgent nephrology evaluation and further workup for underlying renal pathology.</td></tr></table></div>"
            },
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                  "code": "48767-8",
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        "status": "final",
        "subject": {
          "reference": "urn:uuid:2d9bbd1a-437b-4071-a7bd-78869de4835b",
          "display": "Meaghan Neary"
        },
        "date": "2024-08-20T00:11:04Z",
        "title": "Laboratory Report",
        "confidentiality": "N"
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          {
            "reference": "urn:uuid:baa30f65-14e8-45ed-a335-fecefcc6660a"
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          {
            "reference": "urn:uuid:fa5ab39e-3592-4254-9579-7419ff6f51c4"
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          {
            "reference": "urn:uuid:c49a40a8-16fe-48b9-8dd0-02200279259d"
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          {
            "reference": "urn:uuid:39ff5ba4-2733-4d7c-8dca-625293f99b3e"
          },
          {
            "reference": "urn:uuid:e4233d04-1030-418e-8818-4c2a4e895d63"
          }
        ],
        "status": "registered",
        "code": {
          "coding": [
            {
              "code": "11502-2",
              "system": "http://loinc.org",
              "display": "Laboratory report"
            }
          ]
        },
        "subject": {
          "reference": "urn:uuid:2d9bbd1a-437b-4071-a7bd-78869de4835b",
          "display": "Meaghan Neary"
        }
      }
    },
    {
      "fullUrl": "urn:uuid:2d9bbd1a-437b-4071-a7bd-78869de4835b",
      "resource": {
        "resourceType": "Patient",
        "id": "2d9bbd1a-437b-4071-a7bd-78869de4835b",
        "meta": {
          "security": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "HTEST"
            },
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
              "code": "TRAIN"
            }
          ],
          "tag": [
            {
              "system": "https://synderai.net/fhir/CodeSystem/tags",
              "code": "synthetic",
              "display": "SYNDERAI Synthetic data"
            }
          ],
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/patient-eu-core"
          ]
        },
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "code": "PT",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
                }
              ]
            },
            "system": "http://ec.europa.eu/identifier/eci",
            "value": "1586-567257-8"
          },
          {
            "type": {
              "coding": [
                {
                  "code": "MR",
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203"
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              ]
            },
            "system": "http://local.setting.eu/identifier",
            "value": "443e6379-f231-b364-3ccb-644740a1aa2a"
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        ],
        "name": [
          {
            "family": "Neary"
          },
          {
            "given": [
              "Meaghan"
            ]
          },
          {
            "text": "Meaghan Neary"
          }
        ],
        "address": [
          {
            "line": [
              "64 Linskey Street"
            ],
            "use": "home",
            "type": "physical",
            "postalCode": "D02",
            "city": "Dublin",
            "country": "Ireland"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "001-967-573-0911x465"
          }
        ],
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality",
            "valueCodeableConcept": {
              "coding": [
                {
                  "code": "IE",
                  "system": "http://hl7.org/fhir/ValueSet/country"
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              ]
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Meaghan Neary</td><td>female</td><td>19-Dec-1960</td></tr></table></div>"
        },
        "gender": "female",
        "birthDate": "1960-12-19"
      }
    },
    {
      "fullUrl": "urn:uuid:3bb2f28b-1478-4d0b-8181-40eb7a004687",
      "resource": {
        "resourceType": "ServiceRequest",
        "id": "3bb2f28b-1478-4d0b-8181-40eb7a004687",
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          "coding": [
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              "code": "5811-5",
              "system": "http://loinc.org",
              "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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              "code": "5803-2",
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          "text": "pH of Urine by Test strip"
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              "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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              "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"
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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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              "display": "Hemoglobin [Presence] in Urine by Test strip"
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          "text": "Hemoglobin [Presence] in Urine by Test strip"
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        },
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              "code": "5799-2",
              "system": "http://loinc.org",
              "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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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>20-Aug-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td></tr></table></div>"
        },
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        "code": {
          "coding": [
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              "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": 4,
          "unit": "%",
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              "display": "Glucose [Mass/volume] in Blood"
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          ],
          "text": "Glucose [Mass/volume] in Blood"
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          "value": 97.5,
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          ],
          "text": "Urea nitrogen [Mass/volume] in Blood"
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          ],
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          "text": "Sodium [Moles/volume] in Blood"
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          "value": 138.5,
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        "code": {
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              "display": "Potassium [Moles/volume] in Blood"
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          ],
          "text": "Potassium [Moles/volume] in Blood"
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        "valueQuantity": {
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          "value": 5.1,
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              "display": "Chloride [Moles/volume] in Blood"
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          ],
          "text": "Chloride [Moles/volume] in Blood"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 102.1,
          "unit": "mmol/L",
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              "display": "Carbon dioxide, total [Moles/volume] in Blood"
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        "version": [
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        "text": {
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        "meta": {
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        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Laboratory Role Id: 35cc20ac-209b-4c74-95f7-330a213e5532</div>"
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        "practitioner": {
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        ],
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              "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>"
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  "type": "document",
  "timestamp": "2024-08-20T00:11:04Z"
}