9, 'completed_at' => '2026-09-06T01:30:00+05:30', 'patient' => [ 'id' => 11, 'uhid' => 'A26080000011', 'name' => 'DEVENDER SINGH', 'gender' => 'male', 'dob' => '1979-03-28', 'abha_id' => '91510165305101', 'abha_address' => 'singhdevender0328@sbx', ], 'doctor' => [ 'id' => 4, 'name' => 'Dr. R.K.SUNDRIYAL', 'hpr_id' => 'HPR-4', ], 'organization' => [ 'id' => 'IN0510000871', 'name' => 'E-Atria Hospital', ], 'encounter' => [ 'id' => 9, 'ipd_no' => 'A26090000009', 'start' => '2026-08-28T10:00:00+05:30', 'end' => '2026-09-06T01:30:00+05:30', 'class_code' => 'IMP', 'location_display' => 'Ward: General Ward, Bed: GW-12', ], 'chief_complaints' => [ ['name' => 'Abdominal Pain', 'code' => '21522000'], ['name' => 'Cough', 'code' => '49727002'], ['name' => 'Vomiting', 'code' => '422400008'], ['name' => 'Acute chest pain', 'code' => '423341008'], ['name' => 'Chest Pain', 'code' => '29857009'], ], 'diagnoses' => [ ['name' => 'VIRAL DISEASE', 'code' => '404684003'], ], 'procedures' => [ ['name' => 'Laparoscopy of rectum', 'code' => '86174004'], ], 'medications' => [ [ 'name' => 'ACILOC', 'dosage' => 'Take 1 tablet twice daily before meals', 'frequency' => 2, 'period_unit' => 'd', 'route' => 'Oral route', ], [ 'name' => 'PANTOP DSR', 'dosage' => 'Take 1 tablet once daily before meals', 'frequency' => 1, 'period_unit' => 'd', 'route' => 'Oral route', ], ], 'observations' => [ [ 'text' => 'Pulse /min', 'value' => '70', 'category' => 'Condition on Admission Time', 'loinc_code' => '8867-4', 'loinc_display' => 'Heart rate', ], [ 'text' => 'Respiration /min', 'value' => '20', 'category' => 'Condition on Admission Time', 'loinc_code' => '9279-1', 'loinc_display' => 'Respiratory rate', ], [ 'text' => 'BP mmHg', 'value' => '140/90', 'category' => 'Condition on Admission Time', 'loinc_code' => '85354-9', 'loinc_display' => 'Blood pressure panel with all children optional', ], [ 'text' => 'SPO2', 'value' => '95', 'category' => 'Condition on Admission Time', 'loinc_code' => '59408-5', 'loinc_display' => 'Oxygen saturation in Arterial blood by Pulse oximetry', ], [ 'text' => 'Temp F', 'value' => '96', 'category' => 'Condition on Admission Time', 'loinc_code' => '8310-5', 'loinc_display' => 'Body temperature', ], ], 'care_plans' => [ [ 'title' => 'Dietary Advice', 'description' => 'Fruits and Vegetables: Consume fresh fruits and vegetables daily. Avoid processed, sugary, and salty foods.', ], [ 'title' => 'Follow Up', 'description' => 'Review After: 1 Month (02-10-2026) / as and when required', ], ], 'documents' => [] ]; $bundle = [ "resourceType" => "Bundle", "id" => "discharge-A26090000009-v" . time(), "meta" => [ "versionId" => "1", "lastUpdated" => "2026-09-06T02:08:00+05:30", "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle" ], "security" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/v3-Confidentiality", "code" => "V", "display" => "very restricted" ] ] ], "identifier" => [ "system" => "https://hms.local/fhir/document", "value" => "discharge-A26090000009-v" . time() ], "type" => "document", "timestamp" => "2026-09-06T02:08:00+05:30", "entry" => [ // Entry 0: Composition [ "fullUrl" => "urn:uuid:fdf46837-ab78-42a7-a550-8d64a35b6508", "resource" => [ "resourceType" => "Composition", "id" => "fdf46837-ab78-42a7-a550-8d64a35b6508", "meta" => [ "versionId" => "1", "lastUpdated" => "2026-09-06T02:08:00+05:30", "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord" ] ], "status" => "final", "type" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "373942005", "display" => "Discharge summary" ] ], "text" => "Discharge Summary" ], "title" => "IPD Discharge Summary", "date" => "2026-09-06T02:08:00+05:30", "subject" => [ "reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH" ], "encounter" => [ "reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e", "display" => "Encounter" ], "author" => [ [ "reference" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "display" => "Dr. R.K.SUNDRIYAL" ] ], "custodian" => [ "reference" => "urn:uuid:41fddd40-0707-47b6-a22b-17a70e068116", "display" => "E-Atria Hospital" ], "section" => [ [ "title" => "Chief complaints", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "422843007", "display" => "Chief complaint section" ] ] ], "entry" => [ ["reference" => "urn:uuid:ee9837f1-95a6-41fc-aa4f-f245744fc8c6", "display" => "Abdominal Pain"], ["reference" => "urn:uuid:e6d1cece-4973-46d4-ace5-d96047401b20", "display" => "Cough"], ["reference" => "urn:uuid:a712dc95-6feb-4b11-a7ea-5699b8845317", "display" => "Vomiting"], ["reference" => "urn:uuid:9eb5f7ed-afc9-47e4-a693-c3984efe1da2", "display" => "Acute chest pain"], ["reference" => "urn:uuid:3399f570-c2c6-4d1e-aee1-0ed8a0d751df", "display" => "Chest Pain"] ] ], [ "title" => "Clinical History and Risk Profile", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "1003642006", "display" => "Past medical history section" ] ] ], "entry" => [ ["reference" => "urn:uuid:8b4f1234-cad1-49ea-8822-111111111111", "display" => "Coronary artery disease (CAD)"], ["reference" => "urn:uuid:8b4f1234-cva1-49ea-8822-222222222222", "display" => "Cerebral vascular accident (CVA)"], ["reference" => "urn:uuid:8b4f1234-alco-49ea-8822-333333333333", "display" => "Alcohol History"] ] ], [ "title" => "Discharge Diagnosis", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "397659008", "display" => "Discharge diagnosis" ] ] ], "entry" => [ ["reference" => "urn:uuid:3a84e6c1-a483-4cde-a4a3-9b3ba8d5ebf7", "display" => "VIRAL DISEASE"] ] ], [ "title" => "Procedures", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "371525003", "display" => "Clinical procedure report" ] ] ], "entry" => [ ["reference" => "urn:uuid:95411403-5e4f-4c93-acee-fe7457d5acf5", "display" => "Laparoscopy of rectum"] ] ], [ "title" => "Discharge Medications", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "721981007", "display" => "Medication list" ] ] ], "entry" => [ ["reference" => "urn:uuid:a89d0861-d785-4103-aa88-9cb79c119e6d", "display" => "ACILOC"], ["reference" => "urn:uuid:657d375d-6fa1-4971-a112-a789d9b2904d", "display" => "PANTOP DSR"] ] ], [ "title" => "General Examination on Admission", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "425044008", "display" => "Physical exam section" ] ] ], "entry" => [ ["reference" => "urn:uuid:07c74196-8d31-4ccb-a290-a84f979e5f35", "display" => "Pulse"], ["reference" => "urn:uuid:e9902963-cbbf-4b27-a3c6-d374f324e33e", "display" => "Respiration"], ["reference" => "urn:uuid:bc6a18f9-ea89-47c6-a99d-850ddfbce149", "display" => "BP"], ["reference" => "urn:uuid:ee80de1f-986e-46b1-a3d2-8f23a23df5c0", "display" => "SPO2"], ["reference" => "urn:uuid:0fb54648-cd56-4c91-a092-813469aa7c67", "display" => "Temp"] ] ], [ "title" => "Follow-Up Instructions", "code" => [ "coding" => [ [ "system" => "http://snomed.info/sct", "code" => "736271009", "display" => "Follow-up plan" ] ] ], "entry" => [ ["reference" => "urn:uuid:1b57be60-c849-4bd7-a090-7da51d4ab193", "display" => "Dietary Advice"], ["reference" => "urn:uuid:6ef6f128-d10a-4a3b-a660-5cfb966d29ff", "display" => "Follow Up"] ] ] ] ] ], // Entry 1: Patient [ "fullUrl" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "resource" => [ "resourceType" => "Patient", "id" => "11cef8a6-4cd1-4733-afd0-92898eb57901", "meta" => [ "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient" ] ], "identifier" => [ [ "type" => [ "coding" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/v2-0203", "code" => "MR", "display" => "Medical record number" ] ] ], "system" => "https://hms.local/patient-id", "value" => "11" ], [ "type" => [ "coding" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/v2-0203", "code" => "SB", "display" => "Social Beneficiary Identifier" ] ] ], "system" => "https://healthid.ndhm.gov.in", "value" => "91510165305101" ] ], "name" => [ [ "use" => "official", "text" => "DEVENDER SINGH" ] ], "gender" => "male", "birthDate" => "1979-03-28" ] ], // Entry 2: Practitioner [ "fullUrl" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "resource" => [ "resourceType" => "Practitioner", "id" => "0c561894-fc78-4bb9-ab25-a2aa05c739e6", "meta" => [ "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner" ] ], "identifier" => [ [ "type" => [ "coding" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/v2-0203", "code" => "MD", "display" => "Medical License number" ] ] ], "system" => "https://doctor.ndhm.gov.in", "value" => "HPR-4" ] ], "name" => [ [ "use" => "official", "text" => "Dr. R.K.SUNDRIYAL" ] ] ] ], // Entry 3: Organization [ "fullUrl" => "urn:uuid:41fddd40-0707-47b6-a22b-17a70e068116", "resource" => [ "resourceType" => "Organization", "id" => "41fddd40-0707-47b6-a22b-17a70e068116", "meta" => [ "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization" ] ], "identifier" => [ [ "type" => [ "coding" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/v2-0203", "code" => "PRN", "display" => "Provider number" ] ] ], "system" => "https://facility.ndhm.gov.in", "value" => "IN0510000871" ] ], "name" => "E-Atria Hospital" ] ], // Entry 4: Encounter [ "fullUrl" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e", "resource" => [ "resourceType" => "Encounter", "id" => "4dd35d04-72c8-468f-afae-a82e1e51cd9e", "meta" => [ "profile" => [ "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter" ] ], "status" => "finished", "class" => [ "system" => "http://terminology.hl7.org/CodeSystem/v3-ActCode", "code" => "IMP", "display" => "inpatient encounter" ], "subject" => [ "reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH" ], "period" => [ "start" => "2026-08-28T10:00:00+05:30", "end" => "2026-09-06T02:08:00+05:30" ], "hospitalization" => [ "dischargeDisposition" => [ "coding" => [ [ "system" => "http://terminology.hl7.org/CodeSystem/discharge-disposition", "code" => "home", "display" => "Home" ] ], "text" => "Discharged to Home Care" ] ], "serviceProvider" => [ "reference" => "urn:uuid:41fddd40-0707-47b6-a22b-17a70e068116", "display" => "E-Atria Hospital" ] ] ], // Chief complaints [ "fullUrl" => "urn:uuid:ee9837f1-95a6-41fc-aa4f-f245744fc8c6", "resource" => [ "resourceType" => "Condition", "id" => "ee9837f1-95a6-41fc-aa4f-f245744fc8c6", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "21522000", "display" => "Abdominal pain"]], "text" => "Abdominal Pain"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:e6d1cece-4973-46d4-ace5-d96047401b20", "resource" => [ "resourceType" => "Condition", "id" => "e6d1cece-4973-46d4-ace5-d96047401b20", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "49727002", "display" => "Cough"]], "text" => "Cough"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:a712dc95-6feb-4b11-a7ea-5699b8845317", "resource" => [ "resourceType" => "Condition", "id" => "a712dc95-6feb-4b11-a7ea-5699b8845317", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "422400008", "display" => "Vomiting"]], "text" => "Vomiting"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:9eb5f7ed-afc9-47e4-a693-c3984efe1da2", "resource" => [ "resourceType" => "Condition", "id" => "9eb5f7ed-afc9-47e4-a693-c3984efe1da2", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "423341008", "display" => "Acute chest pain"]], "text" => "Acute chest pain"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:3399f570-c2c6-4d1e-aee1-0ed8a0d751df", "resource" => [ "resourceType" => "Condition", "id" => "3399f570-c2c6-4d1e-aee1-0ed8a0d751df", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "29857009", "display" => "Chest pain"]], "text" => "Chest Pain"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], // Clinical History & Risk Profile [ "fullUrl" => "urn:uuid:8b4f1234-cad1-49ea-8822-111111111111", "resource" => [ "resourceType" => "Condition", "id" => "8b4f1234-cad1-49ea-8822-111111111111", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "problem-list-item", "display" => "Problem List Item"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "53741008", "display" => "Coronary artery disease"]], "text" => "Coronary artery disease (CAD)"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:8b4f1234-cva1-49ea-8822-222222222222", "resource" => [ "resourceType" => "Condition", "id" => "8b4f1234-cva1-49ea-8822-222222222222", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "problem-list-item", "display" => "Problem List Item"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "230690007", "display" => "Cerebrovascular accident"]], "text" => "Cerebral vascular accident (CVA)"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], [ "fullUrl" => "urn:uuid:8b4f1234-alco-49ea-8822-333333333333", "resource" => [ "resourceType" => "Observation", "id" => "8b4f1234-alco-49ea-8822-333333333333", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "social-history", "display" => "Social History"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "160573003", "display" => "Alcohol intake"]], "text" => "Lifestyle and Personal History: Alcohol"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "valueString" => "Alcohol" ] ], // Discharge Diagnosis [ "fullUrl" => "urn:uuid:3a84e6c1-a483-4cde-a4a3-9b3ba8d5ebf7", "resource" => [ "resourceType" => "Condition", "id" => "3a84e6c1-a483-4cde-a4a3-9b3ba8d5ebf7", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition"]], "clinicalStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" => "active", "display" => "Active"]]], "verificationStatus" => ["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-ver-status", "code" => "confirmed", "display" => "Confirmed"]]], "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/condition-category", "code" => "encounter-diagnosis", "display" => "Encounter Diagnosis"]]]], "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "404684003", "display" => "Clinical finding"]], "text" => "VIRAL DISEASE"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "recordedDate" => "2026-09-06T02:08:00+05:30" ] ], // Procedure [ "fullUrl" => "urn:uuid:95411403-5e4f-4c93-acee-fe7457d5acf5", "resource" => [ "resourceType" => "Procedure", "id" => "95411403-5e4f-4c93-acee-fe7457d5acf5", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Procedure"]], "status" => "completed", "code" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "86174004", "display" => "Laparoscopy"]], "text" => "Laparoscopy of rectum"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "performedDateTime" => "2026-08-28T00:00:00+05:30" ] ], // Medications [ "fullUrl" => "urn:uuid:a89d0861-d785-4103-aa88-9cb79c119e6d", "resource" => [ "resourceType" => "MedicationRequest", "id" => "a89d0861-d785-4103-aa88-9cb79c119e6d", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/MedicationRequest"]], "status" => "active", "intent" => "order", "medicationCodeableConcept" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "105904009", "display" => "Type of drug"]], "text" => "ACILOC"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "authoredOn" => "2026-09-06T02:08:00+05:30", "requester" => ["reference" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "display" => "Dr. R.K.SUNDRIYAL"], "dosageInstruction" => [[ "text" => "Take 1 tablet twice daily before meals", "timing" => ["repeat" => ["frequency" => 2, "period" => 1, "periodUnit" => "d"]], "route" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "26643006", "display" => "Oral route"]]], "doseAndRate" => [["doseQuantity" => ["value" => 1, "unit" => "Tablet", "system" => "http://unitsofmeasure.org", "code" => "tbl"]]] ]] ] ], [ "fullUrl" => "urn:uuid:657d375d-6fa1-4971-a112-a789d9b2904d", "resource" => [ "resourceType" => "MedicationRequest", "id" => "657d375d-6fa1-4971-a112-a789d9b2904d", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/MedicationRequest"]], "status" => "active", "intent" => "order", "medicationCodeableConcept" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "105904009", "display" => "Type of drug"]], "text" => "PANTOP DSR"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "authoredOn" => "2026-09-06T02:08:00+05:30", "requester" => ["reference" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "display" => "Dr. R.K.SUNDRIYAL"], "dosageInstruction" => [[ "text" => "Take 1 tablet once daily before meals", "timing" => ["repeat" => ["frequency" => 1, "period" => 1, "periodUnit" => "d"]], "route" => ["coding" => [["system" => "http://snomed.info/sct", "code" => "26643006", "display" => "Oral route"]]], "doseAndRate" => [["doseQuantity" => ["value" => 1, "unit" => "Tablet", "system" => "http://unitsofmeasure.org", "code" => "tbl"]]] ]] ] ], // Physical Exam Vitals [ "fullUrl" => "urn:uuid:07c74196-8d31-4ccb-a290-a84f979e5f35", "resource" => [ "resourceType" => "Observation", "id" => "07c74196-8d31-4ccb-a290-a84f979e5f35", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "vital-signs", "display" => "Vital Signs"]]]], "code" => ["coding" => [["system" => "http://loinc.org", "code" => "8867-4", "display" => "Heart rate"]], "text" => "Pulse /min"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "valueQuantity" => ["value" => 70, "unit" => "/min", "system" => "http://unitsofmeasure.org", "code" => "/min"] ] ], [ "fullUrl" => "urn:uuid:e9902963-cbbf-4b27-a3c6-d374f324e33e", "resource" => [ "resourceType" => "Observation", "id" => "e9902963-cbbf-4b27-a3c6-d374f324e33e", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "vital-signs", "display" => "Vital Signs"]]]], "code" => ["coding" => [["system" => "http://loinc.org", "code" => "9279-1", "display" => "Respiratory rate"]], "text" => "Respiration /min"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "valueQuantity" => ["value" => 20, "unit" => "/min", "system" => "http://unitsofmeasure.org", "code" => "/min"] ] ], [ "fullUrl" => "urn:uuid:bc6a18f9-ea89-47c6-a99d-850ddfbce149", "resource" => [ "resourceType" => "Observation", "id" => "bc6a18f9-ea89-47c6-a99d-850ddfbce149", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "vital-signs", "display" => "Vital Signs"]]]], "code" => ["coding" => [["system" => "http://loinc.org", "code" => "85354-9", "display" => "Blood pressure panel with all children optional"]], "text" => "BP mmHg"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "component" => [ [ "code" => ["coding" => [["system" => "http://loinc.org", "code" => "8480-6", "display" => "Systolic blood pressure"]], "text" => "Systolic blood pressure"], "valueQuantity" => ["value" => 140, "unit" => "mmHg", "system" => "http://unitsofmeasure.org", "code" => "mm[Hg]"] ], [ "code" => ["coding" => [["system" => "http://loinc.org", "code" => "8462-4", "display" => "Diastolic blood pressure"]], "text" => "Diastolic blood pressure"], "valueQuantity" => ["value" => 90, "unit" => "mmHg", "system" => "http://unitsofmeasure.org", "code" => "mm[Hg]"] ] ] ] ], [ "fullUrl" => "urn:uuid:ee80de1f-986e-46b1-a3d2-8f23a23df5c0", "resource" => [ "resourceType" => "Observation", "id" => "ee80de1f-986e-46b1-a3d2-8f23a23df5c0", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "vital-signs", "display" => "Vital Signs"]]]], "code" => ["coding" => [["system" => "http://loinc.org", "code" => "59408-5", "display" => "Oxygen saturation in Arterial blood by Pulse oximetry"]], "text" => "SPO2"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "valueQuantity" => ["value" => 95, "unit" => "%", "system" => "http://unitsofmeasure.org", "code" => "%"] ] ], [ "fullUrl" => "urn:uuid:0fb54648-cd56-4c91-a092-813469aa7c67", "resource" => [ "resourceType" => "Observation", "id" => "0fb54648-cd56-4c91-a092-813469aa7c67", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation"]], "status" => "final", "category" => [["coding" => [["system" => "http://terminology.hl7.org/CodeSystem/observation-category", "code" => "vital-signs", "display" => "Vital Signs"]]]], "code" => ["coding" => [["system" => "http://loinc.org", "code" => "8310-5", "display" => "Body temperature"]], "text" => "Temp F"], "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "effectiveDateTime" => "2026-08-28T10:00:00+05:30", "valueQuantity" => ["value" => 96, "unit" => "degF", "system" => "http://unitsofmeasure.org", "code" => "[degF]"] ] ], // Follow-Up Instructions (CarePlans) [ "fullUrl" => "urn:uuid:1b57be60-c849-4bd7-a090-7da51d4ab193", "resource" => [ "resourceType" => "CarePlan", "id" => "1b57be60-c849-4bd7-a090-7da51d4ab193", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CarePlan"]], "status" => "active", "intent" => "plan", "category" => [["coding" => [["system" => "http://snomed.info/sct", "code" => "736271009", "display" => "Outpatient care plan"]]]], "title" => "Dietary Advice", "description" => "Fruits and Vegetables: Consume fresh fruits and vegetables daily. Avoid processed, sugary, and salty foods.", "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "author" => ["reference" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "display" => "Dr. R.K.SUNDRIYAL"] ] ], [ "fullUrl" => "urn:uuid:6ef6f128-d10a-4a3b-a660-5cfb966d29ff", "resource" => [ "resourceType" => "CarePlan", "id" => "6ef6f128-d10a-4a3b-a660-5cfb966d29ff", "meta" => ["profile" => ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CarePlan"]], "status" => "active", "intent" => "plan", "category" => [["coding" => [["system" => "http://snomed.info/sct", "code" => "736271009", "display" => "Outpatient care plan"]]]], "title" => "Follow Up", "description" => "Review After: 1 Month (02-10-2026) / as and when required", "subject" => ["reference" => "urn:uuid:11cef8a6-4cd1-4733-afd0-92898eb57901", "display" => "DEVENDER SINGH"], "encounter" => ["reference" => "urn:uuid:4dd35d04-72c8-468f-afae-a82e1e51cd9e"], "author" => ["reference" => "urn:uuid:0c561894-fc78-4bb9-ab25-a2aa05c739e6", "display" => "Dr. R.K.SUNDRIYAL"] ] ] ] ]; $validator = new \App\Libraries\Abdm\Fhir\Support\FhirBundleValidator(); $val = $validator->validate($bundle); echo "Validation Result (Without PDF):\n"; echo "Valid: " . ($val->valid ? "YES" : "NO") . " | Score: " . $val->score . "%\n"; echo "Total Entries: " . count($bundle['entry']) . "\n"; if (!empty($val->errors)) { echo "Errors: " . print_r($val->errors, true) . "\n"; } file_put_contents(__DIR__ . '/bundle_without_pdf.json', json_encode($bundle, JSON_PRETTY_PRINT | JSON_UNESCAPED_SLASHES));