<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="Shire1StructuredR01"/>
  <language value="en"/>
  <identifier>
    <value value="SHIRE:CPP:RTST-260416-2"/>
  </identifier>
  <type value="message"/>
  <timestamp value="2026-04-16T11:09:00+00:00"/>
  <entry>
    <fullUrl value="urn:uuid:09eefbd5-5414-4d7e-80db-82b8d0cdeaba"/>
    <resource>
      <MessageHeader>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_null"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader </b></p><p><b>event</b>: <a href="http://terminology.hl7.org/7.3.0/CodeSystem-v2-0003.html#v2-0003-R01">event: R01</a> (ORU/ACK - Unsolicited transmission of an observation message)</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style="display: none">*</td><td><a href="https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=http://fhir.org/packages/fhir.r4.ukcore.stu3.currentbuild/https//fhir.mft.nhs.uk/Endpoint/HODS">https//fhir.mft.nhs.uk/Endpoint/HODS</a></td><td>Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/HODS</td></tr></table><p><b>sender</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/CPP</p><h3>Sources</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Software</b></td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td>NW GLH</td><td><a href="https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE">https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE</a></td></tr></table><p><b>focus</b>: <a href="Bundle-Shire1StructuredR01.html#urn-uuid-d918c758-03a0-42e8-9da7-1586e6369980">Diagnostic Report for 'Karyotype [Identifier] in Bone marrow Nominal' for '-&gt;SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)'</a></p></div>
        </text>
        <eventCoding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0003"/>
          <code value="R01"/>
        </eventCoding>
        <destination>
          <endpoint value="https//fhir.mft.nhs.uk/Endpoint/HODS"/>
          <receiver>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="HODS"/>
            </identifier>
          </receiver>
        </destination>
        <sender>
          <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
            <value value="CPP"/>
          </identifier>
        </sender>
        <source>
          <software value="NW GLH"/>
          <endpoint value="https://fhir.nwgenomics.nhs.uk/Endpoint/SHIRE"/>
        </source>
        <focus>
          <reference value="urn:uuid:d918c758-03a0-42e8-9da7-1586e6369980"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"/>
    <resource>
      <Patient>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_null"> </a><p class="res-header-id"><b>Generated Narrative: Patient </b></p><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</p><hr/></div>
        </text>
        <identifier>
          <extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus">
            <valueCodeableConcept>
              <coding>
                <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland"/>
                <code value="05"/>
                <display value="Trace needs to be resolved - (NHS number or patient detail conflict)"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="NH"/>
            </coding>
          </type>
          <system value="https://fhir.nhs.uk/Id/nhs-number"/>
          <value value="9737383192"/>
        </identifier>
        <name>
          <family value="MANCHESTER"/>
          <given value="SANSA"/>
        </name>
        <gender value="female"/>
        <birthDate value="1972-09-21"/>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1d085155-0068-4cfe-b3ba-0fac6fcd630b"/>
    <resource>
      <Observation>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_null"> </a><p class="res-header-id"><b>Generated Narrative: Observation </b></p><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 62356-1}">Chromosome analysis result in ISCN expression</span></p><p><b>subject</b>: <a href="Bundle-Shire1StructuredR01.html#urn-uuid-dad58958-991b-4431-bd91-35c113dfafb8">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</a></p><p><b>value</b>: 46,XY,del(20)(q*q*)[]</p><p><b>note</b>: </p><blockquote><div><p>Chromosome analysis has shown an abnormal karyotype with a deletion in the long arm of chromosome 20.</p>
</div></blockquote></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
            <code value="laboratory"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="62356-1"/>
            <display value="Chromosome analysis result in ISCN expression"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"/>
        </subject>
        <valueString value="46,XY,del(20)(q*q*)[]"/>
        <note>
          <text value="Chromosome analysis has shown an abnormal karyotype with a deletion in the long arm of chromosome 20."/>
        </note>
      </Observation>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:72387d7b-3b87-4845-875e-7910cd245b7f"/>
    <resource>
      <Observation>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_null"> </a><p class="res-header-id"><b>Generated Narrative: Observation </b></p><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 62389-2}">Chromosome analysis master panel</span></p><p><b>subject</b>: <a href="Bundle-Shire1StructuredR01.html#urn-uuid-dad58958-991b-4431-bd91-35c113dfafb8">SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</a></p><p><b>hasMember</b>: <a href="Bundle-Shire1StructuredR01.html#urn-uuid-1d085155-0068-4cfe-b3ba-0fac6fcd630b">Observation Chromosome analysis result in ISCN expression</a></p></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
            <code value="laboratory"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="62389-2"/>
            <display value="Chromosome analysis master panel"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"/>
        </subject>
        <hasMember>
          <reference value="urn:uuid:1d085155-0068-4cfe-b3ba-0fac6fcd630b"/>
        </hasMember>
      </Observation>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:d918c758-03a0-42e8-9da7-1586e6369980"/>
    <resource>
      <DiagnosticReport>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="DiagnosticReport_null"> </a><p class="res-header-id"><b>Generated Narrative: DiagnosticReport </b></p><h2><span title="Codes:{http://loinc.org 33893-9}">Karyotype [Identifier] in Bone marrow Nominal</span> (<span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span>) </h2><table class="grid"><tr><td>Subject</td><td>SANSA MANCHESTER  Female, DoB: 1972-09-21 ( National Health Plan Identifier)</td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td></tr><tr><td><a href="Bundle-Shire1StructuredR01.html#urn-uuid-72387d7b-3b87-4845-875e-7910cd245b7f"><span title="Codes:{http://loinc.org 62389-2}">Chromosome analysis master panel</span></a></td><td/><td>Final</td></tr></table></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="33893-9"/>
            <display value="Karyotype [Identifier] in Bone marrow Nominal"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:dad58958-991b-4431-bd91-35c113dfafb8"/>
        </subject>
        <result>
          <reference value="urn:uuid:72387d7b-3b87-4845-875e-7910cd245b7f"/>
        </result>
      </DiagnosticReport>
    </resource>
  </entry>
</Bundle>