MSH|^~\&|ADM|LMH|||201905311816||ADT^A06|3959672|D|2.2|||AL|NE
EVN|A06|201905311816||||201905311800
PID|1|FHATVIG0009431|LM00005339|LM5189|ADMTESTOR^SYDNEY^JANE|JOGINDER|19770917|F|||5310 NIPTUCK ROAD^^FORT LANGLEY^BC^V3X 5P4|||||||LM000427/19|
PV1|1|I|LM-ERIN2^LMERINZ2-2^R12|UE||LM.AMBN|TEST12345^TEST12345^^^^^^^^^^^XX|||EMED||||||||IN|||||||||||||||||||||LMH|||||201905311800|
PV2||W^Ward|FELL AT WORK
OBX|1|CE|ADM ACC VE^Requested Accommodation Verified?^ADM||M^MEDICAL (PA USE ONLY)||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20090531||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCSWP^BC Services With Photo||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|7|CE|ADM TPL^Third Party Liability?^ADM||U^Unknown||||||F
OBX|8|CE|INS WCBAP^Anatomical Positions (Side of Body)^INS||N^No||||||F
OBX|9|TX|INS WCBBP^Body Part^INS||23100||||||F
OBX|10|TX|INS WCBNOI^Nature of Injury^INS||99990||||||F
GT1|1||ADMTESTOR^SYDNEY^JANE||5310 NIPTUCK ROAD^^FORT LANGLEY^BC^V3X 5P4||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||.ERGP^Generic^ER^Physician^^^^^OTH||TEST12345^TEST12345^^^^^^^DOC|TEST12345^TEST12345^^^^^^^DOC|#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED|201905301625|2||||
