diff --git a/.Net Capstone Project/MedplumFhirService.cs b/.Net Capstone Project/MedplumFhirService.cs
new file mode 100644
index 0000000..91a07e2
--- /dev/null
+++ b/.Net Capstone Project/MedplumFhirService.cs	
@@ -0,0 +1,282 @@
+using ClinicalInsightsPro.API.Data;
+using ClinicalInsightsPro.API.DTOs;
+using ClinicalInsightsPro.API.Services.Interfaces;
+using Microsoft.EntityFrameworkCore;
+using System.Text.Json;
+
+namespace ClinicalInsightsPro.API.Services;
+
+public class MedplumFhirService : IMedplumFhirService
+{
+    private readonly ApplicationDbContext _db;
+    private readonly ILogger<MedplumFhirService> _logger;
+
+    public MedplumFhirService(
+        ApplicationDbContext db,
+        ILogger<MedplumFhirService> logger)
+    {
+        _db = db;
+        _logger = logger;
+    }
+
+    public Task<List<JsonElement>> GetMedplumResourcesAsync(string resourceType, string? patientId = null)
+    {
+        // Offline/demo mode has normalized tables, not the raw Medplum store.
+        // The unified Medplum browser is intentionally live-only so the UI
+        // always shows actual FHIR JSON when the feature is enabled.
+        throw new InvalidOperationException(
+            "The Medplum resource browser requires Fhir:UseLiveMedplum=true. " +
+            "Set MEDPLUM_USE_LIVE=true and configure MEDPLUM_BASE_URL, " +
+            "MEDPLUM_TOKEN_URL, MEDPLUM_CLIENT_ID and MEDPLUM_CLIENT_SECRET.");
+    }
+
+    public async Task<List<PatientSummaryDto>> GetPatientListAsync()
+    {
+        var patients = await _db.Patient
+            .AsNoTracking()
+            .OrderBy(x => x.GivenName)
+            .ThenBy(x => x.FamilyName)
+            .ToListAsync();
+
+        return patients.Select(p => new PatientSummaryDto
+        {
+            Id = p.Id,
+            FullName = $"{p.GivenName} {p.FamilyName}",
+            Age = CalculateAge(p.BirthDate),
+            Gender = p.Gender,
+            MedicalRecordNumber = p.MedicalRecordNumber
+        }).ToList();
+    }
+
+    public async Task<PatientChartDto> GetPatientChartAsync(string patientId)
+    {
+        var patient = await _db.Patient
+            .AsNoTracking()
+            .FirstOrDefaultAsync(p => p.Id == patientId);
+
+        if (patient == null)
+        {
+            throw new KeyNotFoundException(
+                $"Patient '{patientId}' was not found.");
+        }
+
+        var conditions = await _db.Condition
+            .AsNoTracking()
+            .Where(x => x.PatientId == patientId)
+            .OrderByDescending(x => x.RecordedDate)
+            .ToListAsync();
+
+        var observations = await _db.Observation
+            .AsNoTracking()
+            .Where(x => x.PatientId == patientId)
+            .OrderByDescending(x => x.EffectiveDateTime)
+            .ToListAsync();
+
+        var allergies = await _db.AllergyIntolerance
+            .AsNoTracking()
+            .Where(x => x.PatientId == patientId)
+            .ToListAsync();
+
+        var medications = await _db.MedicationRequest
+            .AsNoTracking()
+            .Where(x => x.PatientId == patientId)
+            .ToListAsync();
+
+        var encounters = await _db.Encounter
+            .AsNoTracking()
+            .Where(x => x.PatientId == patientId)
+            .OrderByDescending(x => x.PeriodStart)
+            .ToListAsync();
+
+        _logger.LogInformation(
+            "Retrieved chart for patient {PatientId}",
+            patientId);
+
+        return new PatientChartDto
+        {
+            PatientId = patient.Id,
+
+            FullName = $"{patient.GivenName} {patient.FamilyName}",
+
+            Age = CalculateAge(patient.BirthDate),
+
+            MedicalRecordNumber = patient.MedicalRecordNumber,
+
+            IdentifierSystem = patient.IdentifierSystem,
+            IdentifierValue = patient.IdentifierValue,
+
+            NameUse = patient.NameUse,
+            Prefix = patient.Prefix,
+
+            GivenName = patient.GivenName,
+            FamilyName = patient.FamilyName,
+
+            TelecomSystem = patient.TelecomSystem,
+            TelecomUse = patient.TelecomUse,
+            TelecomValue = patient.TelecomValue,
+
+            Gender = patient.Gender,
+
+            BloodGroup = patient.BloodGroup,
+            Email = patient.Email,
+
+            BirthDate = patient.BirthDate,
+
+            AddressUse = patient.AddressUse,
+            AddressType = patient.AddressType,
+            AddressLine = patient.AddressLine,
+
+            City = patient.City,
+            State = patient.State,
+            PostalCode = patient.PostalCode,
+
+            MaritalStatusSystem = patient.MaritalStatusSystem,
+            MaritalStatusCode = patient.MaritalStatusCode,
+            MaritalStatusDisplay = patient.MaritalStatusDisplay,
+
+            ContactNameUse = patient.ContactNameUse,
+            ContactPrefix = patient.ContactPrefix,
+
+            ContactTelecomSystem = patient.ContactTelecomSystem,
+            ContactTelecomUse = patient.ContactTelecomUse,
+            ContactTelecomValue = patient.ContactTelecomValue,
+
+            ContactAddressUse = patient.ContactAddressUse,
+            ContactAddressType = patient.ContactAddressType,
+            ContactAddressLine = patient.ContactAddressLine,
+
+            ContactCity = patient.ContactCity,
+            ContactState = patient.ContactState,
+            ContactPostalCode = patient.ContactPostalCode,
+
+            ContactGender = patient.ContactGender,
+            ContactOrganizationId = patient.ContactOrganizationId,
+
+            ContactPeriodStart = patient.ContactPeriodStart,
+            ContactPeriodEnd = patient.ContactPeriodEnd,
+
+            ManagingOrganizationId = patient.ManagingOrganizationId,
+
+            PhotoContentType = patient.PhotoContentType,
+            PhotoUrl = patient.PhotoUrl,
+            PhotoTitle = patient.PhotoTitle,
+
+            GeneralPractitionerId = patient.GeneralPractitionerId,
+
+            Conditions = conditions.Select(c => new ChartConditionDto
+            {
+                Id = c.Id,
+                Code = c.ConditionCode,
+                Display = c.ConditionDisplay,
+                ClinicalStatus = c.ClinicalStatusDisplay,
+                VerificationStatus = c.VerificationStatusDisplay,
+                Severity = c.SeverityDisplay,
+                OnsetDate = c.OnsetDateTime,
+                AbatementDate = c.AbatementDateTime,
+                RecordedDate = c.RecordedDate
+            }).ToList(),
+
+            Allergies = allergies.Select(a => new ChartAllergyDto
+            {
+                Id = a.Id,
+                Type = a.Type,
+                ClinicalStatus = a.ClinicalStatus,
+                VerificationStatus = a.VerificationStatus,
+                Criticality = a.Criticality,
+                RecorderPractitionerId = a.RecorderPractitionerId
+            }).ToList(),
+
+            Medications = medications.Select(m => new ChartMedicationDto
+            {
+                Id = m.Id,
+                MedicationCode = m.MedicationCode,
+                MedicationDisplay = m.MedicationDisplay,
+                Status = m.Status,
+                Intent = m.Intent,
+                Priority = m.Priority
+            }).ToList(),
+
+            Observations = observations.Select(o => new ChartObservationDto
+            {
+                Id = o.Id,
+                Code = o.ObservationCode,
+                Display = o.ObservationDisplay,
+                Status = o.Status,
+                CategoryDisplay = o.CategoryDisplay,
+                InterpretationCode = o.InterpretationCode,
+                InterpretationDisplay = o.InterpretationDisplay,
+                EffectiveDate = o.EffectiveDateTime,
+                NoteText = o.NoteText
+            }).ToList(),
+
+            Encounters = encounters.Select(e => new ChartEncounterDto
+            {
+                Id = e.Id,
+                Status = e.Status,
+                ClassCode = e.ClassCode,
+                ClassDisplay = e.ClassDisplay,
+                TypeDisplay = e.TypeDisplay,
+                ServiceTypeDisplay = e.ServiceTypeDisplay,
+                PeriodStart = e.PeriodStart,
+                PeriodEnd = e.PeriodEnd
+            }).ToList()
+        };
+    }
+
+    private static int CalculateAge(DateTime birthDate)
+    {
+        var today = DateTime.UtcNow;
+
+        var age = today.Year - birthDate.Year;
+
+        if (birthDate.Date > today.AddYears(-age))
+        {
+            age--;
+        }
+
+        return age;
+    }
+
+    // ---- Two-way sync additions ----
+    // This class is the OFFLINE/local implementation (used when
+    // Fhir:UseLiveMedplum=false) — it reads/writes only the local database
+    // and never talks to a real Medplum server, so there is nothing to push
+    // or pull here. These methods exist only so this class still satisfies
+    // IMedplumFhirService; they throw/no-op with a clear message instead of
+    // silently pretending to sync. Set MEDPLUM_USE_LIVE=true in .env to
+    // switch the app over to LiveMedplumFhirService, which implements the
+    // real sync against Medplum's FHIR API.
+    public Task<string> CreatePatientInMedplumAsync(Models.Patient patient)
+    {
+        _logger.LogWarning(
+            "CreatePatientInMedplumAsync called while running in offline/local mode " +
+            "(Fhir:UseLiveMedplum=false) — patient {Id} was saved locally only, not pushed to Medplum. " +
+            "Set MEDPLUM_USE_LIVE=true in .env to enable Medplum sync.", patient.Id);
+        return Task.FromResult(string.Empty);
+    }
+
+    public Task UpdatePatientInMedplumAsync(Models.Patient patient)
+    {
+        _logger.LogWarning(
+            "UpdatePatientInMedplumAsync called while running in offline/local mode " +
+            "(Fhir:UseLiveMedplum=false) — patient {Id} was updated locally only, not pushed to Medplum.", patient.Id);
+        return Task.CompletedTask;
+    }
+
+    public Task DeletePatientInMedplumAsync(string medplumId)
+    {
+        _logger.LogWarning(
+            "DeletePatientInMedplumAsync called while running in offline/local mode " +
+            "(Fhir:UseLiveMedplum=false) — nothing was deleted in Medplum.");
+        return Task.CompletedTask;
+    }
+
+    public Task<List<Models.Patient>> PullAllPatientsFromMedplumAsync()
+    {
+        _logger.LogWarning(
+            "PullAllPatientsFromMedplumAsync called while running in offline/local mode " +
+            "(Fhir:UseLiveMedplum=false) — returning an empty list. Set MEDPLUM_USE_LIVE=true in .env " +
+            "to pull real data from Medplum.");
+        return Task.FromResult(new List<Models.Patient>());
+    }
+}
\ No newline at end of file