@precisa-saude/fhir-rnds-sandbox 0.1.0

package/LICENSE

@@ -0,0 +1,201 @@
+                                 Apache License
+                           Version 2.0, January 2004
+                        http://www.apache.org/licenses/
+
+   TERMS AND CONDITIONS FOR USE, REPRODUCTION, AND DISTRIBUTION
+
+   1. Definitions.
+
+      "License" shall mean the terms and conditions for use, reproduction,
+      and distribution as defined by Sections 1 through 9 of this document.
+
+      "Licensor" shall mean the copyright owner or entity authorized by
+      the copyright owner that is granting the License.
+
+      "Legal Entity" shall mean the union of the acting entity and all
+      other entities that control, are controlled by, or are under common
+      control with that entity. For the purposes of this definition,
+      "control" means (i) the power, direct or indirect, to cause the
+      direction or management of such entity, whether by contract or
+      otherwise, or (ii) ownership of fifty percent (50%) or more of the
+      outstanding shares, or (iii) beneficial ownership of such entity.
+
+      "You" (or "Your") shall mean an individual or Legal Entity
+      exercising permissions granted by this License.
+
+      "Source" form shall mean the preferred form for making modifications,
+      including but not limited to software source code, documentation
+      source, and configuration files.
+
+      "Object" form shall mean any form resulting from mechanical
+      transformation or translation of a Source form, including but
+      not limited to compiled object code, generated documentation,
+      and conversions to other media types.
+
+      "Work" shall mean the work of authorship, whether in Source or
+      Object form, made available under the License, as indicated by a
+      copyright notice that is included in or attached to the work
+      (an example is provided in the Appendix below).
+
+      "Derivative Works" shall mean any work, whether in Source or Object
+      form, that is based on (or derived from) the Work and for which the
+      editorial revisions, annotations, elaborations, or other modifications
+      represent, as a whole, an original work of authorship. For the purposes
+      of this License, Derivative Works shall not include works that remain
+      separable from, or merely link (or bind by name) to the interfaces of,
+      the Work and Derivative Works thereof.
+
+      "Contribution" shall mean any work of authorship, including
+      the original version of the Work and any modifications or additions
+      to that Work or Derivative Works thereof, that is intentionally
+      submitted to Licensor for inclusion in the Work by the copyright owner
+      or by an individual or Legal Entity authorized to submit on behalf of
+      the copyright owner. For the purposes of this definition, "submitted"
+      means any form of electronic, verbal, or written communication sent
+      to the Licensor or its representatives, including but not limited to
+      communication on electronic mailing lists, source code control systems,
+      and issue tracking systems that are managed by, or on behalf of, the
+      Licensor for the purpose of discussing and improving the Work, but
+      excluding communication that is conspicuously marked or otherwise
+      designated in writing by the copyright owner as "Not a Contribution."
+
+      "Contributor" shall mean Licensor and any individual or Legal Entity
+      on behalf of whom a Contribution has been received by Licensor and
+      subsequently incorporated within the Work.
+
+   2. Grant of Copyright License. Subject to the terms and conditions of
+      this License, each Contributor hereby grants to You a perpetual,
+      worldwide, non-exclusive, no-charge, royalty-free, irrevocable
+      copyright license to reproduce, prepare Derivative Works of,
+      publicly display, publicly perform, sublicense, and distribute the
+      Work and such Derivative Works in Source or Object form.
+
+   3. Grant of Patent License. Subject to the terms and conditions of
+      this License, each Contributor hereby grants to You a perpetual,
+      worldwide, non-exclusive, no-charge, royalty-free, irrevocable
+      (except as stated in this section) patent license to make, have made,
+      use, offer to sell, sell, import, and otherwise transfer the Work,
+      where such license applies only to those patent claims licensable
+      by such Contributor that are necessarily infringed by their
+      Contribution(s) alone or by combination of their Contribution(s)
+      with the Work to which such Contribution(s) was submitted. If You
+      institute patent litigation against any entity (including a
+      cross-claim or counterclaim in a lawsuit) alleging that the Work
+      or a Contribution incorporated within the Work constitutes direct
+      or contributory patent infringement, then any patent licenses
+      granted to You under this License for that Work shall terminate
+      as of the date such litigation is filed.
+
+   4. Redistribution. You may reproduce and distribute copies of the
+      Work or Derivative Works thereof in any medium, with or without
+      modifications, and in Source or Object form, provided that You
+      meet the following conditions:
+
+      (a) You must give any other recipients of the Work or
+          Derivative Works a copy of this License; and
+
+      (b) You must cause any modified files to carry prominent notices
+          stating that You changed the files; and
+
+      (c) You must retain, in the Source form of any Derivative Works
+          that You distribute, all copyright, patent, trademark, and
+          attribution notices from the Source form of the Work,
+          excluding those notices that do not pertain to any part of
+          the Derivative Works; and
+
+      (d) If the Work includes a "NOTICE" text file as part of its
+          distribution, then any Derivative Works that You distribute must
+          include a readable copy of the attribution notices contained
+          within such NOTICE file, excluding those notices that do not
+          pertain to any part of the Derivative Works, in at least one
+          of the following places: within a NOTICE text file distributed
+          as part of the Derivative Works; within the Source form or
+          documentation, if provided along with the Derivative Works; or,
+          within a display generated by the Derivative Works, if and
+          wherever such third-party notices normally appear. The contents
+          of the NOTICE file are for informational purposes only and
+          do not modify the License. You may add Your own attribution
+          notices within Derivative Works that You distribute, alongside
+          or as an addendum to the NOTICE text from the Work, provided
+          that such additional attribution notices cannot be construed
+          as modifying the License.
+
+      You may add Your own copyright statement to Your modifications and
+      may provide additional or different license terms and conditions
+      for use, reproduction, or distribution of Your modifications, or
+      for any such Derivative Works as a whole, provided Your use,
+      reproduction, and distribution of the Work otherwise complies with
+      the conditions stated in this License.
+
+   5. Submission of Contributions. Unless You explicitly state otherwise,
+      any Contribution intentionally submitted for inclusion in the Work
+      by You to the Licensor shall be under the terms and conditions of
+      this License, without any additional terms or conditions.
+      Notwithstanding the above, nothing herein shall supersede or modify
+      the terms of any separate license agreement you may have executed
+      with Licensor regarding such Contributions.
+
+   6. Trademarks. This License does not grant permission to use the trade
+      names, trademarks, service marks, or product names of the Licensor,
+      except as required for reasonable and customary use in describing the
+      origin of the Work and reproducing the content of the NOTICE file.
+
+   7. Disclaimer of Warranty. Unless required by applicable law or
+      agreed to in writing, Licensor provides the Work (and each
+      Contributor provides its Contributions) on an "AS IS" BASIS,
+      WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or
+      implied, including, without limitation, any warranties or conditions
+      of TITLE, NON-INFRINGEMENT, MERCHANTABILITY, or FITNESS FOR A
+      PARTICULAR PURPOSE. You are solely responsible for determining the
+      appropriateness of using or redistributing the Work and assume any
+      risks associated with Your exercise of permissions under this License.
+
+   8. Limitation of Liability. In no event and under no legal theory,
+      whether in tort (including negligence), contract, or otherwise,
+      unless required by applicable law (such as deliberate and grossly
+      negligent acts) or agreed to in writing, shall any Contributor be
+      liable to You for damages, including any direct, indirect, special,
+      incidental, or consequential damages of any character arising as a
+      result of this License or out of the use or inability to use the
+      Work (including but not limited to damages for loss of goodwill,
+      work stoppage, computer failure or malfunction, or any and all
+      other commercial damages or losses), even if such Contributor
+      has been advised of the possibility of such damages.
+
+   9. Accepting Warranty or Additional Liability. While redistributing
+      the Work or Derivative Works thereof, You may choose to offer,
+      and charge a fee for, acceptance of support, warranty, indemnity,
+      or other liability obligations and/or rights consistent with this
+      License. However, in accepting such obligations, You may act only
+      on Your own behalf and on Your sole responsibility, not on behalf
+      of any other Contributor, and only if You agree to indemnify,
+      defend, and hold each Contributor harmless for any liability
+      incurred by, or claims asserted against, such Contributor by reason
+      of your accepting any such warranty or additional liability.
+
+   END OF TERMS AND CONDITIONS
+
+   APPENDIX: How to apply the Apache License to your work.
+
+      To apply the Apache License to your work, attach the following
+      boilerplate notice, with the fields enclosed by brackets "[]"
+      replaced with your own identifying information. (Don't include
+      the brackets!)  The text should be enclosed in the appropriate
+      comment syntax for the file format. We also recommend that a
+      file or class name and description of purpose be included on the
+      same "printed page" as the copyright notice for easier
+      identification within third-party archives.
+
+   Copyright [yyyy] [name of copyright owner]
+
+   Licensed under the Apache License, Version 2.0 (the "License");
+   you may not use this file except in compliance with the License.
+   You may obtain a copy of the License at
+
+       http://www.apache.org/licenses/LICENSE-2.0
+
+   Unless required by applicable law or agreed to in writing, software
+   distributed under the License is distributed on an "AS IS" BASIS,
+   WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+   See the License for the specific language governing permissions and
+   limitations under the License.

package/README.md

@@ -0,0 +1,477 @@
+# @precisa-saude/fhir-rnds-sandbox
+
+> Mock local da RNDS (Rede Nacional de Dados em Saúde) — endpoints FHIR R4
+> com cenários sintéticos para desenvolvimento, ensino e demos.
+
+[![License: Apache 2.0](https://img.shields.io/badge/License-Apache%202.0-blue.svg)](https://www.apache.org/licenses/LICENSE-2.0)
+
+Sem certificado ICP-Brasil. Sem credenciamento DATASUS. Roda em segundos.
+
+## Por que existe
+
+Testar uma integração com a RNDS em produção exige certificado ICP-Brasil
+(SERPRO/AC) e homologação no DATASUS — meses de papelada. Esse atrito trava
+hackathons, aulas, PoCs e a adoção de qualquer cliente RNDS, inclusive o
+nosso (`@precisa-saude/fhir-rnds`).
+
+`rnds-sandbox` é um servidor HTTP leve que implementa o subset de endpoints
+FHIR R4 que clientes RNDS usam de fato — busca de paciente por CPF/CNS,
+consulta de organização (CNES) e profissional (CNS), e submissão de Bundle.
+Os dados são sintéticos, claramente falsos e versionados em cenários
+nomeados.
+
+## Instalação
+
+```bash
+npx @precisa-saude/fhir-rnds-sandbox start
+```
+
+Ou como dependência:
+
+```bash
+pnpm add -D @precisa-saude/fhir-rnds-sandbox
+```
+
+## Uso — CLI
+
+```bash
+# sobe na porta padrão 8080 com cenário "paciente-com-exames"
+rnds-sandbox start
+
+# escolhe cenário e porta
+rnds-sandbox start --port 9000 --scenario internacao
+
+# habilita mTLS (cliente precisa apresentar certificado)
+rnds-sandbox start --mtls --pfx ./dev-cert.pfx --pfx-password senha
+
+# lista cenários disponíveis
+rnds-sandbox scenarios
+```
+
+## Uso — programático
+
+```ts
+import { createSandboxServer } from '@precisa-saude/fhir-rnds-sandbox';
+
+const sandbox = createSandboxServer({
+  scenario: 'paciente-com-exames',
+  port: 0, // porta efêmera — útil em testes
+});
+
+const { host, port } = await sandbox.start();
+console.log(`sandbox em http://${host}:${port}`);
+
+// ... rode seus testes ...
+
+await sandbox.stop();
+```
+
+## Cenários
+
+| Nome                  | Descrição                                                                                      |
+| --------------------- | ---------------------------------------------------------------------------------------------- |
+| `paciente-com-exames` | Joana da Silva, 42 anos, com lipidograma + glicemia codificados em LOINC. (padrão)             |
+| `internacao`          | Carlos Souza, 67, internado por insuficiência cardíaca (CID I50.0), com NT-proBNP e troponina. |
+| `vacina`              | Pedro Almeida, 8 anos, com calendário vacinal aplicado (BCG, hepatite B, tríplice viral).      |
+| `vazio`               | Estado limpo. Útil para testar fluxos do zero.                                                 |
+
+Identificadores sintéticos usados nos cenários:
+
+| CPF           | CNS               | Cenário             |
+| ------------- | ----------------- | ------------------- |
+| `12345678901` | `700000000000001` | paciente-com-exames |
+| `98765432100` | `700000000000020` | internacao          |
+| _(sem CPF)_   | `700000000000040` | vacina              |
+
+CNES dos estabelecimentos: `2345678` (lab), `3456789` (hospital), `4567890` (UBS).
+
+### Exemplos por cenário
+
+Todos os exemplos assumem o sandbox rodando em `http://127.0.0.1:8080`. Os
+campos `submittedBundles` listados em cada cenário ficam disponíveis via
+`sandbox.store.getSubmittedBundles()` na API programática (ou seja, são
+"histórico" do paciente — o cliente os consome via outras consultas, não
+por um endpoint dedicado).
+
+#### `paciente-com-exames` (padrão)
+
+```bash
+rnds-sandbox start
+```
+
+Buscar paciente por CPF:
+
+```bash
+$ curl -s "http://127.0.0.1:8080/api/fhir/r4/Patient?identifier=$(printf 'http://rnds.saude.gov.br/fhir/r4/NamingSystem/cpf|12345678901' | jq -sRr @uri)"
+```
+
+```json
+{
+  "resourceType": "Patient",
+  "id": "700000000000001",
+  "identifier": [
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cpf", "value": "12345678901" },
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns", "value": "700000000000001" }
+  ],
+  "name": [{ "family": "Silva", "given": ["Joana", "Maria", "da"] }],
+  "gender": "female",
+  "birthDate": "1983-08-12"
+}
+```
+
+Histórico pré-carregado (Bundle de lipidograma + glicemia, todas as
+Observations codificadas em LOINC):
+
+| LOINC    | Biomarcador      | Valor     |
+| -------- | ---------------- | --------- |
+| `2093-3` | Colesterol total | 198 mg/dL |
+| `2089-1` | LDL-Colesterol   | 124 mg/dL |
+| `2085-9` | HDL-Colesterol   | 56 mg/dL  |
+| `2345-7` | Glicose          | 96 mg/dL  |
+
+Submeter um novo Bundle (resposta abaixo):
+
+```bash
+$ curl -s -X POST http://127.0.0.1:8080/api/fhir/r4/Bundle \
+    -H "Content-Type: application/fhir+json" \
+    -d '{"resourceType":"Bundle","type":"transaction","entry":[{"request":{"method":"POST","url":"Observation"},"resource":{"resourceType":"Observation","status":"final","code":{"coding":[{"system":"http://loinc.org","code":"2345-7","display":"Glicose"}]},"valueQuantity":{"value":102,"unit":"mg/dL","system":"http://unitsofmeasure.org","code":"mg/dL"}}}]}'
+```
+
+```json
+{
+  "resourceType": "Bundle",
+  "type": "transaction-response",
+  "entry": [{ "response": { "status": "201 Created", "location": "Resource/sandbox-1" } }]
+}
+```
+
+#### `internacao`
+
+```bash
+rnds-sandbox start --scenario internacao
+```
+
+Buscar paciente por CNS:
+
+```bash
+$ curl -s http://127.0.0.1:8080/api/fhir/r4/Patient/700000000000020
+```
+
+```json
+{
+  "resourceType": "Patient",
+  "id": "700000000000020",
+  "identifier": [
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cpf", "value": "98765432100" },
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns", "value": "700000000000020" }
+  ],
+  "name": [{ "family": "Souza", "given": ["Carlos", "Henrique"] }],
+  "gender": "male",
+  "birthDate": "1958-02-28"
+}
+```
+
+Buscar o hospital (Organization) pelo CNES:
+
+```bash
+$ curl -s http://127.0.0.1:8080/api/fhir/r4/Organization/3456789
+```
+
+```json
+{
+  "resourceType": "Organization",
+  "id": "3456789",
+  "active": true,
+  "identifier": [
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes", "value": "3456789" }
+  ],
+  "name": "Hospital Sintético do Coração (sandbox)"
+}
+```
+
+Histórico pré-carregado:
+
+| Recurso                       | Detalhe                                            |
+| ----------------------------- | -------------------------------------------------- |
+| `Encounter`                   | classe `IMP` (inpatient), iniciado em 2026-04-15   |
+| `Condition`                   | CID-10 `I50.0` (Insuficiência cardíaca congestiva) |
+| `Observation` LOINC `33762-6` | NT-proBNP — 4820 pg/mL                             |
+| `Observation` LOINC `49563-0` | Troponina I — 0.08 ng/mL                           |
+
+#### `vacina`
+
+```bash
+rnds-sandbox start --scenario vacina
+```
+
+Buscar o paciente pediátrico:
+
+```bash
+$ curl -s http://127.0.0.1:8080/api/fhir/r4/Patient/700000000000040
+```
+
+```json
+{
+  "resourceType": "Patient",
+  "id": "700000000000040",
+  "identifier": [
+    { "system": "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns", "value": "700000000000040" }
+  ],
+  "name": [{ "family": "Almeida", "given": ["Pedro", "Lima"] }],
+  "gender": "male",
+  "birthDate": "2017-11-04"
+}
+```
+
+Histórico pré-carregado (3 `Immunization`, sistema PNI/CVP
+`urn:oid:2.16.840.1.113883.6.59`):
+
+| Vacina               | Código | Data       |
+| -------------------- | ------ | ---------- |
+| BCG                  | `BCG`  | 2017-11-05 |
+| Hepatite B (RN)      | `HBV`  | 2017-11-05 |
+| Tríplice viral (SCR) | `MMR`  | 2018-12-12 |
+
+#### `vazio`
+
+```bash
+rnds-sandbox start --scenario vazio
+```
+
+Toda consulta de leitura retorna `404 OperationOutcome`. Útil para
+exercitar o caminho de erro do cliente:
+
+```bash
+$ curl -s -i http://127.0.0.1:8080/api/fhir/r4/Patient/700000000000001 | head -1
+HTTP/1.1 404 Not Found
+```
+
+```json
+{
+  "resourceType": "OperationOutcome",
+  "issue": [
+    {
+      "severity": "error",
+      "code": "not-found",
+      "diagnostics": "Paciente CNS 700000000000001 não encontrado"
+    }
+  ]
+}
+```
+
+## Endpoints
+
+Compatível com o subset usado por `@precisa-saude/fhir-rnds`:
+
+| Método | Path                                                                                                     | Auth (modo strict)     | Descrição                                                                                                                |
+| ------ | -------------------------------------------------------------------------------------------------------- | ---------------------- | ------------------------------------------------------------------------------------------------------------------------ |
+| `POST` | `/api/token`                                                                                             | mTLS (cert do cliente) | Emite token JWT assinado em RS256.                                                                                       |
+| `GET`  | `/.well-known/jwks.json`                                                                                 | público                | Chave pública (JWK) usada para verificar a assinatura do token.                                                          |
+| `GET`  | `/api/fhir/r4/Patient?identifier={system}\|{value}`                                                      | bearer + CNS           | Busca por CPF (`.../cpf`) ou CNS (`.../cns`).                                                                            |
+| `GET`  | `/api/fhir/r4/Patient/{cns}`                                                                             | bearer + CNS           | Lê paciente por CNS.                                                                                                     |
+| `GET`  | `/api/fhir/r4/Organization/{cnes}`                                                                       | bearer + CNS           | Lê estabelecimento por CNES.                                                                                             |
+| `GET`  | `/api/fhir/r4/Practitioner/{cns}`                                                                        | bearer + CNS           | Lê profissional por CNS.                                                                                                 |
+| `POST` | `/api/fhir/r4/Bundle`                                                                                    | bearer + CNS           | Aceita Bundle transaction/batch e retorna transaction-response.                                                          |
+| `GET`  | `/api/fhir/r4/{Observation\|DiagnosticReport\|Immunization\|Condition\|Encounter}?subject=Patient/{cns}` | bearer + CNS           | Retorna searchset Bundle com recursos pré-carregados + submetidos. Aceita também `?patient=...` ou só o CNS sem prefixo. |
+
+Em modo **permissivo** (padrão sem flags) nenhum auth é exigido — qualquer
+curl entra. Recursos não encontrados retornam `404` com `OperationOutcome`.
+Endpoints FHIR exigem dois headers em modo strict (igual à API real):
+
+- `X-Authorization-Server: Bearer <jwt>` — token RS256 emitido pelo sandbox
+- `Authorization: <CNS>` — CNS de 15 dígitos do profissional requisitante
+
+## Modos de fidelidade
+
+O sandbox tem três modos. Escolha o que combina com o que você quer
+demonstrar/testar:
+
+| Modo           | Como ativar               | Comportamento                                                                                                                                                                    |
+| -------------- | ------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
+| **Permissivo** | (sem flags)               | HTTP puro, qualquer chamada aceita. Útil para curl, aulas e iteração rápida.                                                                                                     |
+| **Strict**     | `--strict`                | HTTP, mas /api/fhir/r4/\* exige bearer + CNS, e /api/token exige cert mTLS apresentado (rejeita sem). Útil para validar a lógica de auth do cliente sem precisar configurar TLS. |
+| **mTLS**       | `--mtls` (implica strict) | HTTPS com handshake mTLS opcional do cliente. Réplica fiel da RNDS: cert exigido em /api/token; FHIR API exige bearer.                                                           |
+
+### JWT — RS256 com JWKS
+
+O token é um JWT RS256 real, assinado com uma chave RSA-2048. Por padrão
+a chave é gerada **efêmera** no boot — bom para devs que rodam o sandbox
+em sessões curtas. Em CI/demos onde você quer reusar o mesmo token entre
+restarts, passe `--jwt-private-key`:
+
+```bash
+# gere uma chave estável (uma vez)
+openssl genpkey -algorithm RSA -pkeyopt rsa_keygen_bits:2048 -out jwt.pem
+
+rnds-sandbox start --strict --jwt-private-key ./jwt.pem
+```
+
+A chave pública é exposta via `/.well-known/jwks.json`. Bibliotecas de JWT
+(`jose`, `jsonwebtoken`, `jwt.io` com a URL do JWKS) podem verificar a
+assinatura sem configuração fora-de-banda:
+
+```bash
+$ curl -s http://127.0.0.1:8080/.well-known/jwks.json | jq
+{
+  "keys": [
+    {
+      "alg": "RS256",
+      "e": "AQAB",
+      "kid": "rnds-sandbox-1",
+      "kty": "RSA",
+      "n": "qdg8rAyVCT0s7UA4YM_j6fjjLt_-0huK7sQyLT...",
+      "use": "sig"
+    }
+  ]
+}
+```
+
+### Validação contra perfis do IG
+
+Por padrão o sandbox valida cada `Bundle.entry[i].resource` enviado em
+`POST /api/fhir/r4/Bundle` contra os perfis `BR*` do IG `fhir-brasil`
+(`BRPatient`, `BRLabObservation`, `BRDiagnosticReport`). Bundles que
+violam restrições são rejeitados com `422 OperationOutcome` listando
+todas as issues — formato e códigos espelham o que a RNDS real
+retorna.
+
+```bash
+# Patient sem campos obrigatórios — o sandbox responde 422 com a lista
+$ curl -s -X POST http://127.0.0.1:8080/api/fhir/r4/Bundle \
+    -H 'Content-Type: application/fhir+json' \
+    -d '{"resourceType":"Bundle","type":"transaction","entry":[
+        {"request":{"method":"POST","url":"Patient"},
+         "resource":{"resourceType":"Patient"}}
+      ]}'
+```
+
+```json
+{
+  "resourceType": "OperationOutcome",
+  "issue": [
+    {
+      "severity": "error",
+      "code": "required",
+      "diagnostics": "Patient.identifier requer pelo menos 1 elemento(s); recebido 0",
+      "location": ["Bundle.entry[0].resource.identifier"]
+    },
+    {
+      "severity": "error",
+      "code": "required",
+      "diagnostics": "Patient.name requer pelo menos 1 elemento(s); recebido 0",
+      "location": ["Bundle.entry[0].resource.name"]
+    },
+    {
+      "severity": "error",
+      "code": "required",
+      "diagnostics": "Patient.birthDate é obrigatório",
+      "location": ["Bundle.entry[0].resource.birthDate"]
+    },
+    {
+      "severity": "error",
+      "code": "required",
+      "diagnostics": "Patient.gender é obrigatório",
+      "location": ["Bundle.entry[0].resource.gender"]
+    }
+  ]
+}
+```
+
+O resolver de perfil usa `meta.profile` quando presente; caso contrário
+seleciona pelo `resourceType` (`Patient` → BRPatient, `Observation` →
+BRLabObservation, `DiagnosticReport` → BRDiagnosticReport). Outros
+tipos passam sem checagem de perfil — declare `meta.profile` se quiser
+conformidade estrita para tipos fora desse conjunto.
+
+Para desligar (e voltar ao comportamento "aceita qualquer Bundle
+estruturalmente válido", útil em aulas):
+
+```bash
+rnds-sandbox start --no-validate
+# ou programaticamente:
+createSandboxServer({ validateSubmissions: false });
+```
+
+As regras espelham as restrições FSH em `ig/input/fsh/profiles/`. São
+implementadas em pure TS (zero deps novas) e cobrem o subset que a
+RNDS real rejeita na prática (cardinalidade, identifiers brasileiros,
+coding LOINC/UCUM, value sets de status). Não pretendem ser FHIR
+validation completa — slicing complexo, value-set binding contra
+terminologias externas e algumas invariantes FHIRPath ficam de fora.
+
+### mTLS na prática
+
+Você precisa de um cert para o **servidor**. Qualquer cert auto-assinado
+serve, ou use o que já tiver (cert ICP-Brasil de homologação, por
+exemplo). O sandbox aceita certs de cliente sem validar a CA
+(`rejectUnauthorized: false`) — propósito: dev, não produção.
+
+```bash
+# 1. Gere cert auto-assinado para o servidor (uma vez)
+openssl req -newkey rsa:2048 -nodes -keyout srv.key -x509 \
+  -days 365 -out srv.crt -subj "/CN=rnds-sandbox.local"
+
+# 2. Suba com mTLS — aceita PFX OU key+cert PEM
+rnds-sandbox start --mtls --server-key ./srv.key --server-cert ./srv.crt
+
+# (alternativa) PFX:
+openssl pkcs12 -export -out srv.pfx -inkey srv.key -in srv.crt -password pass:dev
+rnds-sandbox start --mtls --pfx ./srv.pfx --pfx-password dev
+```
+
+Para apresentar um cert de cliente no curl (e receber CN/CNES embutidos
+no token):
+
+```bash
+# Gere um cert de cliente que embute CNES "1234567" no CN
+openssl req -newkey rsa:2048 -nodes -keyout client.key -x509 \
+  -days 365 -out client.crt \
+  -subj "/CN=PRECISA SAUDE LTDA:1234567"
+
+# Pega token via mTLS — note --cacert + --cert
+TOKEN=$(curl -sk \
+  --cert client.crt --key client.key \
+  -X POST https://127.0.0.1:8443/api/token | jq -r .access_token)
+
+# Decodifique para conferir cn/cnes nas claims (jwt.io ou jq):
+echo "$TOKEN" | cut -d. -f2 | base64 -d 2>/dev/null | jq
+# → { "iss": "...", "sub": "PRECISA SAUDE LTDA:1234567",
+#     "cnes": "1234567", "cn": "PRECISA SAUDE LTDA:1234567", ... }
+
+# Use o token + CNS do profissional na chamada FHIR:
+curl -sk https://127.0.0.1:8443/api/fhir/r4/Patient/700000000000001 \
+  -H "X-Authorization-Server: Bearer $TOKEN" \
+  -H "Authorization: 700000000000010"
+```
+
+## Docker
+
+```bash
+docker run --rm -p 8080:8080 ghcr.io/precisa-saude/fhir-rnds-sandbox:latest
+```
+
+Escolha cenário e porta:
+
+```bash
+docker run --rm -p 9000:9000 ghcr.io/precisa-saude/fhir-rnds-sandbox:latest \
+  start --port 9000 --scenario internacao
+```
+
+## Aviso de produção
+
+Este pacote é estritamente para **desenvolvimento, testes e ensino**.
+Tokens são RS256-assinados, mas com chave gerada localmente (não da RNDS)
+— a assinatura é cryptograficamente válida no escopo do sandbox e nada
+mais. Dados são sintéticos. Não submeta dados de pacientes reais a este
+servidor — ele apenas armazena em memória e perde o estado quando
+reinicia.
+
+## Aviso médico
+
+Os recursos FHIR retornados pelo sandbox **não constituem** registros de
+saúde reais. Cenários são fictícios e ilustrativos. Não use para tomar
+decisões clínicas.
+
+## Licença
+
+Apache-2.0 © Precisa Saúde