fix(abdm): deduplicate chief complaints and medical history, fix medication coding to NRCES spec, and resilient instruction parsing

app/Commands/ResyncDischarge.php

@@ -72,6 +72,14 @@ class ResyncDischarge extends BaseCommand
                     }
                 }
 
+                CLI::write("\nConditions:", 'cyan');
+                foreach ($entries as $e) {
+                    if (($e['resource']['resourceType'] ?? '') === 'Condition') {
+                        $c = $e['resource'];
+                        CLI::write("  - ID: " . ($c['id'] ?? '') . " | Text: " . ($c['code']['text'] ?? ''));
+                    }
+                }
+
                 CLI::write("\nMedicationRequests:", 'cyan');
                 foreach ($entries as $e) {
                     if (($e['resource']['resourceType'] ?? '') === 'MedicationRequest') {

app/Controllers/AbdmGateway.php

@@ -3429,13 +3429,6 @@ class AbdmGateway extends BaseController
             ? date('Y-m-d', strtotime($dischargeDate))
             : ($admissionDate !== '' ? date('Y-m-d', strtotime($admissionDate)) : date('Y-m-d'));
 
-        $diagnoses = [];
-        foreach ($this->ipdRows('ipd_discharge_diagnosis', ['comp_report'], $ipdId) as $row) {
-            $text = trim((string) ($row['comp_report'] ?? ''));
-            if ($text !== '') {
-                $diagnoses[] = ['text' => $text, 'code' => ''];
-            }
-        }
         $chiefComplaints = [];
         foreach ($this->ipdRows('ipd_discharge_complaint', ['comp_report'], $ipdId) as $row) {
             $text = trim((string) ($row['comp_report'] ?? ''));
@@ -3443,19 +3436,95 @@ class AbdmGateway extends BaseController
                 $chiefComplaints[] = ['text' => $text, 'code' => ''];
             }
         }
+        $chiefComplaintNarrative = trim((string) (($this->ipdRows('ipd_discharge_complaint_remark', ['comp_remark'], $ipdId)[0]['comp_remark'] ?? '')));
+
+        // Build normalized lookup of chief complaints
+        $complaintLookup = [];
+        foreach ($chiefComplaints as $cc) {
+            $t = strtolower(trim((string) ($cc['text'] ?? '')));
+            if ($t !== '') {
+                $complaintLookup[$t] = true;
+                if (str_contains($t, ' - ')) {
+                    $parts = explode(' - ', $t);
+                    $complaintLookup[trim($parts[0])] = true;
+                }
+            }
+        }
+
+        // Fetch instructions early for comorbidities
+        $instructionRows = $this->ipdRows('ipd_discharge_instructions', ['comp_report', 'comp_remark', 'review_after'], $ipdId);
+        $instructionRow = ! empty($instructionRows) ? $instructionRows[0] : [];
+        $instructionMeta = ! empty($instructionRow) ? $this->parseJsonArray((string) ($instructionRow['comp_report'] ?? '')) : [];
+        $nabhMeta = is_array($instructionMeta['nabh'] ?? null) ? $instructionMeta['nabh'] : [];
+
+        // Build diagnoses / medical history
+        $diagnoses = [];
+        foreach ($this->ipdRows('ipd_discharge_diagnosis', ['comp_report'], $ipdId) as $row) {
+            $text = trim((string) ($row['comp_report'] ?? ''));
+            if ($text !== '' && ! isset($complaintLookup[strtolower($text)])) {
+                $diagnoses[] = ['text' => $text, 'code' => ''];
+            }
+        }
+
+        // Add comorbidities from NABH
+        $coMorbRaw = trim((string) ($nabhMeta['co_morbidities'] ?? ''));
+        if ($coMorbRaw !== '') {
+            $coMorbParts = preg_split('/[,;\n]+/', $coMorbRaw);
+            foreach ($coMorbParts as $cPart) {
+                $cText = trim((string) $cPart);
+                if ($cText !== '' && $this->isMeaningfulClinicalValue($cText) && ! isset($complaintLookup[strtolower($cText)])) {
+                    $diagnoses[] = ['text' => $cText, 'code' => ''];
+                }
+            }
+        }
+
+        // Add chronic conditions from patient_master
+        if ($patientId > 0 && $this->db && $this->db->tableExists('patient_master')) {
+            $historyFields = [
+                'is_smoking' => 'Smoking',
+                'is_alcohol' => 'Alcohol',
+                'is_drug_abuse' => 'Drug Abuse',
+                'is_tobacoo' => 'Tobacco',
+                'is_hypertesion' => 'Hypertension',
+                'is_niddm' => 'Diabetes',
+                'is_diabetes' => 'Diabetes',
+                'is_ischaemic_heart_ds' => 'Ischemic Heart Disease',
+                'is_asthma_copd' => 'Asthma/COPD',
+                'is_bleeding_disorder' => 'Bleeding Disorder',
+                'is_heapatitis_type' => 'Hepatitis',
+                'is_blood_transfusion' => 'Blood Transfusion',
+                'is_hiv_std' => 'HIV/STD',
+                'is_hiv_I_II' => 'HIV/STD',
+                'is_epilepsy' => 'Epilepsy',
+                'is_tb' => 'TB',
+                'is_psychiatric_illness' => 'Psychiatric Illness',
+                'is_thyroid' => 'Thyroid',
+            ];
+            foreach ($historyFields as $f => $label) {
+                if ((int) ($patientRow[$f] ?? 0) === 1 && ! isset($complaintLookup[strtolower($label)])) {
+                    $diagnoses[] = ['text' => $label, 'code' => ''];
+                }
+            }
+        }
+
         if (empty($diagnoses)) {
             $problem = trim((string) ($ipdRow['problem'] ?? ''));
-            if ($problem !== '') {
+            if ($problem !== '' && $this->isMeaningfulClinicalValue($problem) && ! isset($complaintLookup[strtolower($problem)])) {
                 $diagnoses[] = ['text' => $problem, 'code' => ''];
             }
         }
-        if (empty($diagnoses) && ! empty($chiefComplaints)) {
+
-            $diagnoses = $chiefComplaints;
+        // Deduplicate diagnoses
+        $uniqueDiag = [];
+        $seenDiag = [];
+        foreach ($diagnoses as $dRow) {
+            $dt = strtolower(trim((string) ($dRow['text'] ?? '')));
+            if ($dt !== '' && empty($seenDiag[$dt])) {
+                $seenDiag[$dt] = true;
+                $uniqueDiag[] = $dRow;
+            }
         }
-        if (empty($diagnoses) && empty($procedures)) {
+        $diagnoses = $uniqueDiag;
-            $diagnoses[] = ['text' => 'Medical care and evaluation', 'code' => ''];
-        }
-        $chiefComplaintNarrative = trim((string) (($this->ipdRows('ipd_discharge_complaint_remark', ['comp_remark'], $ipdId)[0]['comp_remark'] ?? '')));
         $diagnosisNarrative = trim((string) (($this->ipdRows('ipd_discharge_diagnosis_remark', ['comp_remark'], $ipdId)[0]['comp_remark'] ?? '')));
 
         $procedures = [];
@@ -4300,7 +4369,34 @@ class AbdmGateway extends BaseController
         }
 
         $decoded = json_decode($json, true);
-        return is_array($decoded) ? $decoded : [];
+        if (is_array($decoded)) {
+            return $decoded;
+        }
+
+        // Resilient fallback for truncated JSON strings
+        $cleanIds = [];
+        if (preg_match('/"food_ids"\s*:\s*\[([^\]]*)\]/', $json, $m)) {
+            $cleanIds = array_values(array_filter(array_map('intval', explode(',', $m[1]))));
+        }
+        $extractKey = function (string $key) use ($json): string {
+            if (preg_match('/"' . preg_quote($key, '/') . '"\s*:\s*"([^"]*)/', $json, $m)) {
+                return trim($m[1]);
+            }
+            return '';
+        };
+
+        return [
+            'food_ids' => $cleanIds,
+            'other_text' => $extractKey('other_text'),
+            'nabh' => [
+                'drug_allergy_status' => $extractKey('drug_allergy_status'),
+                'drug_allergy_details' => $extractKey('drug_allergy_details'),
+                'adr_history' => $extractKey('adr_history'),
+                'current_medications' => $extractKey('current_medications'),
+                'co_morbidities' => $extractKey('co_morbidities'),
+                'hpi_note' => $extractKey('hpi_note'),
+            ],
+        ];
     }
 
     private function isMeaningfulClinicalValue(string $value): bool

app/Controllers/Ipd_discharge.php

@@ -5472,7 +5472,32 @@ class Ipd_discharge extends BaseController
 
         $decoded = json_decode($raw, true);
         if (! is_array($decoded)) {
-            return ['food_ids' => [], 'other_text' => '', 'nabh' => []];
+            $cleanIds = [];
+            if (preg_match('/"food_ids"\s*:\s*\[([^\]]*)\]/', $raw, $m)) {
+                $cleanIds = array_values(array_filter(array_map('intval', explode(',', $m[1]))));
+            }
+            $extractKey = function (string $key) use ($raw): string {
+                if (preg_match('/"' . preg_quote($key, '/') . '"\s*:\s*"([^"]*)/', $raw, $m)) {
+                    return trim($m[1]);
+                }
+                return '';
+            };
+            return [
+                'food_ids' => $cleanIds,
+                'other_text' => $extractKey('other_text'),
+                'nabh' => [
+                    'drug_allergy_status' => $extractKey('drug_allergy_status'),
+                    'drug_allergy_details' => $extractKey('drug_allergy_details'),
+                    'adr_history' => $extractKey('adr_history'),
+                    'current_medications' => $extractKey('current_medications'),
+                    'co_morbidities' => $extractKey('co_morbidities'),
+                    'hpi_note' => $extractKey('hpi_note'),
+                    'women_lmp' => $extractKey('women_lmp'),
+                    'women_last_baby' => $extractKey('women_last_baby'),
+                    'women_pregnancy_related' => $extractKey('women_pregnancy_related'),
+                    'women_related_problems' => $extractKey('women_related_problems'),
+                ],
+            ];
         }
 
         $ids = $decoded['food_ids'] ?? [];
@@ -9401,21 +9426,6 @@ class Ipd_discharge extends BaseController
             ? date('Y-m-d', strtotime($dischargeDateRaw))
             : ($admissionDateRaw !== '' ? date('Y-m-d', strtotime($admissionDateRaw)) : date('Y-m-d'));
 
-        $diagnosisRows = $this->byIpdRows('ipd_discharge_diagnosis', ['comp_report'], 'id ASC', $ipdId);
-        $conditionRows = [];
-        foreach ($diagnosisRows as $row) {
-            $text = trim((string) ($row['comp_report'] ?? ''));
-            if ($text !== '') {
-                $conditionRows[] = ['text' => $text, 'code' => ''];
-            }
-        }
-        if (empty($conditionRows) && ! empty($ipdRow['problem'])) {
-            $prob = trim((string) $ipdRow['problem']);
-            if ($this->isMeaningfulDischargeValue($prob)) {
-                $conditionRows[] = ['text' => $prob, 'code' => ''];
-            }
-        }
-
         $chiefComplaintsList = [];
         if ($this->tableHasColumns('ipd_discharge_complaint', ['ipd_id', 'comp_report'])) {
             $complaintRows = $this->byIpdRows('ipd_discharge_complaint', ['comp_report', 'comp_remark'], 'id ASC', $ipdId);
@@ -9439,13 +9449,96 @@ class Ipd_discharge extends BaseController
             $chiefComplaintsList[] = ['text' => $complaintRemarkText, 'code' => ''];
         }
 
-        if (empty($conditionRows) && ! empty($chiefComplaintsList)) {
+        // Build normalized lookup of chief complaints to avoid duplicating them into medical history
-            $conditionRows = $chiefComplaintsList;
+        $complaintLookup = [];
+        foreach ($chiefComplaintsList as $cc) {
+            $t = strtolower(trim((string) ($cc['text'] ?? '')));
+            if ($t !== '') {
+                $complaintLookup[$t] = true;
+                if (str_contains($t, ' - ')) {
+                    $parts = explode(' - ', $t);
+                    $complaintLookup[trim($parts[0])] = true;
+                }
+            }
         }
-        if (empty($conditionRows)) {
+
-            $conditionRows[] = ['text' => 'Medical care and evaluation', 'code' => ''];
+        // Fetch discharge instructions early for comorbidities
+        $instructionRows = $this->byIpdRows('ipd_discharge_instructions', ['comp_report', 'comp_remark', 'review_after'], 'id DESC', $ipdId);
+        $instructionRow = ! empty($instructionRows) ? $instructionRows[0] : [];
+        $instructionMeta = ! empty($instructionRow) ? $this->parseInstructionMetaPayload((string) ($instructionRow['comp_report'] ?? '')) : ['food_ids' => [], 'other_text' => '', 'nabh' => []];
+        $nabhMeta = is_array($instructionMeta['nabh'] ?? null) ? $instructionMeta['nabh'] : [];
+
+        // Build Medical History / Diagnoses (discharge diagnoses + comorbidities + chronic illness, NEVER chief complaints)
+        $medicalHistoryRows = [];
+        $diagnosisRows = $this->byIpdRows('ipd_discharge_diagnosis', ['comp_report'], 'id ASC', $ipdId);
+        foreach ($diagnosisRows as $row) {
+            $text = trim((string) ($row['comp_report'] ?? ''));
+            if ($text !== '' && ! isset($complaintLookup[strtolower($text)])) {
+                $medicalHistoryRows[] = ['text' => $text, 'code' => ''];
+            }
         }
 
+        // Comorbidities from NABH metadata
+        $coMorbRaw = trim((string) ($nabhMeta['co_morbidities'] ?? ''));
+        if ($coMorbRaw !== '') {
+            $coMorbParts = preg_split('/[,;\n]+/', $coMorbRaw);
+            foreach ($coMorbParts as $cPart) {
+                $cText = trim((string) $cPart);
+                if ($cText !== '' && $this->isMeaningfulDischargeValue($cText) && ! isset($complaintLookup[strtolower($cText)])) {
+                    $medicalHistoryRows[] = ['text' => $cText, 'code' => ''];
+                }
+            }
+        }
+
+        // Chronic illness from patient_master
+        if ($patientId > 0 && $this->db->tableExists('patient_master')) {
+            $historyFields = [
+                'is_smoking' => 'Smoking',
+                'is_alcohol' => 'Alcohol',
+                'is_drug_abuse' => 'Drug Abuse',
+                'is_tobacoo' => 'Tobacco',
+                'is_hypertesion' => 'Hypertension',
+                'is_niddm' => 'Diabetes',
+                'is_diabetes' => 'Diabetes',
+                'is_ischaemic_heart_ds' => 'Ischemic Heart Disease',
+                'is_asthma_copd' => 'Asthma/COPD',
+                'is_bleeding_disorder' => 'Bleeding Disorder',
+                'is_heapatitis_type' => 'Hepatitis',
+                'is_blood_transfusion' => 'Blood Transfusion',
+                'is_hiv_std' => 'HIV/STD',
+                'is_hiv_I_II' => 'HIV/STD',
+                'is_epilepsy' => 'Epilepsy',
+                'is_tb' => 'TB',
+                'is_psychiatric_illness' => 'Psychiatric Illness',
+                'is_thyroid' => 'Thyroid',
+            ];
+            foreach ($historyFields as $f => $label) {
+                if ((int) ($patientRow[$f] ?? 0) === 1 && ! isset($complaintLookup[strtolower($label)])) {
+                    $medicalHistoryRows[] = ['text' => $label, 'code' => ''];
+                }
+            }
+        }
+
+        // Problem from IPD record if non-blank and not duplicate of complaints
+        if (empty($medicalHistoryRows) && ! empty($ipdRow['problem'])) {
+            $prob = trim((string) $ipdRow['problem']);
+            if ($this->isMeaningfulDischargeValue($prob) && ! isset($complaintLookup[strtolower($prob)])) {
+                $medicalHistoryRows[] = ['text' => $prob, 'code' => ''];
+            }
+        }
+
+        // Deduplicate medical history rows by text
+        $uniqueMedHistory = [];
+        $seenMedHistory = [];
+        foreach ($medicalHistoryRows as $mRow) {
+            $mt = strtolower(trim((string) ($mRow['text'] ?? '')));
+            if ($mt !== '' && empty($seenMedHistory[$mt])) {
+                $seenMedHistory[$mt] = true;
+                $uniqueMedHistory[] = $mRow;
+            }
+        }
+        $conditionRows = $uniqueMedHistory;
+
         $procedureRows = [];
         foreach ($this->byIpdRows('ipd_discharge_surgery', ['surgery_name', 'surgery_date'], 'id ASC', $ipdId) as $row) {
             $text = trim((string) ($row['surgery_name'] ?? ''));

app/Libraries/Abdm/Fhir/Generators/DischargeFhirGenerator.php

@@ -94,12 +94,35 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
         $patientRef = 'urn:uuid:patient-' . $patientId;
         $encounterRef = is_array($encounter) ? 'urn:uuid:' . (string) ($encounter['id'] ?? '') : null;
 
-        $diagnosesList = (array) ($source['diagnoses'] ?? $source['conditions'] ?? $source['ui_final_diagnosis'] ?? []);
         $chiefComplaintsList = (array) ($source['chief_complaints'] ?? $source['ui_complaints'] ?? []);
+        $rawDiagnosesList = (array) ($source['diagnoses'] ?? $source['conditions'] ?? $source['ui_final_diagnosis'] ?? []);
+
+        // Build normalized lookup of chief complaints to ensure Medical History never duplicates Chief Complaints
+        $complaintLookup = [];
+        foreach ($chiefComplaintsList as $cc) {
+            $t = strtolower(trim((string) ($cc['text'] ?? $cc['name'] ?? '')));
+            if ($t !== '') {
+                $complaintLookup[$t] = true;
+                if (str_contains($t, ' - ')) {
+                    $parts = explode(' - ', $t);
+                    $complaintLookup[trim($parts[0])] = true;
+                }
+            }
+        }
+
+        $diagnosesList = [];
+        $seenDiag = [];
+        foreach ($rawDiagnosesList as $diag) {
+            $dt = strtolower(trim((string) ($diag['text'] ?? $diag['name'] ?? '')));
+            if ($dt !== '' && ! isset($complaintLookup[$dt]) && empty($seenDiag[$dt])) {
+                $seenDiag[$dt] = true;
+                $diagnosesList[] = $diag;
+            }
+        }
 
         if (empty($diagnosesList) && empty($chiefComplaintsList)) {
             $problem = trim((string) ($source['problem'] ?? ''));
-            if ($problem !== '') {
+            if ($problem !== '' && ! isset($complaintLookup[strtolower($problem)])) {
                 $diagnosesList = [['text' => $problem, 'code' => '']];
             } else {
                 $diagnosesList = [['text' => 'Medical care and evaluation', 'code' => '']];
@@ -594,41 +617,81 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
         $chiefComplaintsList = (array) ($source['ui_complaints'] ?? $source['chief_complaints'] ?? []);
         $complaintsNarrative = trim((string) ($source['ui_complaint_narrative'] ?? $source['chief_complaint_narrative'] ?? ''));
         
-        $diagnosesList = (array) ($source['ui_final_diagnosis'] ?? $source['diagnoses'] ?? $source['conditions'] ?? []);
+        $rawDiagnosesList = (array) ($source['ui_final_diagnosis'] ?? $source['diagnoses'] ?? $source['conditions'] ?? []);
         $clinicalHistoryNarrative = trim((string) ($source['ui_clinical_history'] ?? ''));
 
+        // Build normalized lookup of chief complaints
+        $complaintLookup = [];
+        foreach ($chiefComplaintsList as $cc) {
+            $t = strtolower(trim((string) ($cc['text'] ?? $cc['name'] ?? '')));
+            if ($t !== '') {
+                $complaintLookup[$t] = true;
+                if (str_contains($t, ' - ')) {
+                    $parts = explode(' - ', $t);
+                    $complaintLookup[trim($parts[0])] = true;
+                }
+            }
+        }
+
+        $diagnosesList = [];
+        $seenDiag = [];
+        foreach ($rawDiagnosesList as $diag) {
+            $dt = strtolower(trim((string) ($diag['text'] ?? $diag['name'] ?? '')));
+            if ($dt !== '' && ! isset($complaintLookup[$dt]) && empty($seenDiag[$dt])) {
+                $seenDiag[$dt] = true;
+                $diagnosesList[] = $diag;
+            }
+        }
+
         $sectionDefinitions = [];
         // Chief complaints
         if (! empty($chiefComplaintsList) || $complaintsNarrative !== '') {
-            $sectionDefinitions[] = ['title' => 'Chief complaints', 'code' => '422843007', 'display' => 'Chief complaint section', 'prefix' => 'discharge-chief-complaint-', 'items' => $chiefComplaintsList, 'narrative' => $complaintsNarrative];
+            $sectionDefinitions[] = [
+                'title' => 'Chief complaints',
+                'code' => '422843007',
+                'display' => 'Chief complaint section',
+                'prefix' => 'discharge-chief-complaint-',
+                'items' => $chiefComplaintsList,
+                'narrative' => $complaintsNarrative,
+                'entry_display' => 'Condition',
+            ];
         }
 
         // Discharge Diagnosis (Medical History)
         if (! empty($diagnosesList) || $clinicalHistoryNarrative !== '') {
-            $sectionDefinitions[] = ['title' => 'Medical History', 'code' => '1003642006', 'display' => 'Past medical history section', 'prefix' => 'discharge-diagnosis-', 'items' => $diagnosesList, 'narrative' => $clinicalHistoryNarrative];
+            $sectionDefinitions[] = [
+                'title' => 'Medical History',
+                'code' => '1003642006',
+                'display' => 'Past medical history section',
+                'prefix' => 'discharge-diagnosis-',
+                'items' => $diagnosesList,
+                'narrative' => $clinicalHistoryNarrative,
+                'entry_display' => 'Condition',
+            ];
         }
 
         // Surgery / Procedure
         $surgeries = (array) ($source['ui_surgeries'] ?? $source['procedures'] ?? []);
         if (! empty($surgeries)) {
-            $sectionDefinitions[] = ['title' => 'Procedures', 'code' => '1003640003', 'display' => 'History of past procedure section', 'prefix' => 'discharge-procedure-', 'items' => $surgeries];
+            $sectionDefinitions[] = [
+                'title' => 'Procedures',
+                'code' => '1003640003',
+                'display' => 'History of past procedure section',
+                'prefix' => 'discharge-procedure-',
+                'items' => $surgeries,
+                'entry_display' => 'Procedure',
+            ];
         }
 
-        // Medications
+        // Medications - NRCES DischargeSummaryRecord profile specifies SNOMED 1003606003 (Medication history section)
         if (! empty($validMeds)) {
             $sectionDefinitions[] = [
                 'title' => 'Medications',
-                'code' => '721912009',
+                'code' => '1003606003',
-                'display' => 'Medication summary document',
+                'display' => 'Medication history section',
                 'prefix' => 'discharge-medication-',
                 'items' => $validMeds,
-                'additional_coding' => [
+                'entry_display' => 'MedicationRequest',
-                    [
-                        'system' => 'http://snomed.info/sct',
-                        'code' => '1003606003',
-                        'display' => 'Medication history section',
-                    ],
-                ],
             ];
         }
 
@@ -636,23 +699,52 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
         $investigations = (array) ($source['ui_investigations'] ?? $source['investigations'] ?? []);
         $invNarrative = trim((string) ($source['ui_summary_investigation'] ?? ''));
         if (! empty($investigations) || $invNarrative !== '') {
-            $sectionDefinitions[] = ['title' => 'Investigations', 'code' => '721981007', 'display' => 'Diagnostic studies report', 'prefix' => 'discharge-investigation-', 'items' => $investigations, 'narrative' => $invNarrative];
+            $sectionDefinitions[] = [
+                'title' => 'Investigations',
+                'code' => '721981007',
+                'display' => 'Diagnostic studies report',
+                'prefix' => 'discharge-investigation-',
+                'items' => $investigations,
+                'narrative' => $invNarrative,
+                'entry_display' => 'Diagnostic Report',
+            ];
         }
 
         // Care plans / Discharge advice & hospital course
         if (! empty($validCarePlans)) {
-            $sectionDefinitions[] = ['title' => 'Care Plan', 'code' => '734163000', 'display' => 'Care plan', 'prefix' => 'discharge-careplan-', 'items' => $validCarePlans];
+            $sectionDefinitions[] = [
+                'title' => 'Care Plan',
+                'code' => '734163000',
+                'display' => 'Care plan',
+                'prefix' => 'discharge-careplan-',
+                'items' => $validCarePlans,
+                'entry_display' => 'Care plan',
+            ];
         }
 
         // Document Reference
         if (! empty($documentsList)) {
-            $sectionDefinitions[] = ['title' => 'Document Reference', 'code' => '373942005', 'display' => 'Discharge summary', 'prefix' => 'discharge-document-', 'items' => $documentsList];
+            $sectionDefinitions[] = [
+                'title' => 'Document Reference',
+                'code' => '373942005',
+                'display' => 'Discharge summary',
+                'prefix' => 'discharge-document-',
+                'items' => $documentsList,
+                'entry_display' => 'Discharge Summary',
+            ];
         }
 
         // Allergies
         $allergies = (array) ($source['allergies'] ?? []);
         if (! empty($allergies)) {
-            $sectionDefinitions[] = ['title' => 'Allergies', 'code' => '722446000', 'display' => 'Allergy record', 'prefix' => 'discharge-allergy-', 'items' => $allergies];
+            $sectionDefinitions[] = [
+                'title' => 'Allergies',
+                'code' => '722446000',
+                'display' => 'Allergy record',
+                'prefix' => 'discharge-allergy-',
+                'items' => $allergies,
+                'entry_display' => 'AllergyIntolerance',
+            ];
         }
 
         $sections = [];
@@ -660,7 +752,7 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
             $references = [];
             $items = isset($definition['items_indexed']) ? $definition['items_indexed'] : (array) ($definition['items'] ?? []);
             foreach ($items as $idx => $item) {
-                $itemDisplay = $this->cleanPlainText((string) ($item['name'] ?? $item['text'] ?? $item['title'] ?? $definition['title']));
+                $itemDisplay = $definition['entry_display'] ?? $this->cleanPlainText((string) ($item['name'] ?? $item['text'] ?? $item['title'] ?? $definition['title']));
                 if ($itemDisplay === '') {
                     $itemDisplay = $definition['title'];
                 }