MSH|^~\&|ADM|LMH|||201905311808||ADT^A13|3959403|D|2.2|||AL|NE
EVN|A13|201905311808||||201905311804
PID|1|FHATVIG0009429|LM00005337|LM5187|ADMTESTOR^SYDNEY^JANE|MARYAM|19840214|F|||5310 NIPTUCK ROAD^FORT LANGLEY^LANGLEY^BC^V3X 5P4|||||||LM000422/19|
PV1|1|I|LM-ERIN^LMER-IN^10|EL|||TEST12345^TEST12345^^^^^^^^^^^XX|||EMED||||||||IN|||||||||||||||||||||LMH|||||201905301800|
PV2||W^Ward|QUERY LOWER LUMBER INJURY
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20090101||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCSWP^BC Services With Photo||||||F
OBX|3|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|6|CE|ADM TPL^Third Party Liability?^ADM||N^No||||||F
OBX|7|CE|INS WCBAP^Anatomical Positions (Side of Body)^INS||N^No||||||F
OBX|8|TX|INS WCBBP^Body Part^INS||23100||||||F
OBX|9|TX|INS WCBNOI^Nature of Injury^INS||99990||||||F
OBX|10|CE|INS WSBC^Is this a WorkSafeBC claim?^INS||Y^Yes||||||F
GT1|1||ADMTESTOR^SYDNEY^JANE||5310 NIPTUCK ROAD^FORT LANGLEY^LANGLEY^BC^V3X 5P4||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||.ERGP^Generic^ER^Physician^^^^^OTH||TEST12345^TEST12345^^^^^^^DOC|TEST12345^TEST12345^^^^^^^DOC|
ZFH|LUMED|201905301625|2||||
