MSH|^~\&|ADM|SMH|||201911121951||ADT^A04|4103974|D|2.2|||AL|NE
EVN|A04|201911121951||||201911121950
PID|1|FHATVIG0011716|SM00046431|SM46222|ADMSTENTAN^HARSHA^VICKY|HARSHA|19880228|F|||9866 MAPLE HILL DR^^EDMONTON^AB^T5P 3B5|||||||SM003473/19|9874987319
PV1|1|O|SM.AMDC||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||SDC|||||||||||||||||||||SMH|||||201911121950|
PV2|||LAPROSCOPY
OBX|1|TX|ADM AC AUD^HIGH PROFILE PATIENT - ACCESS AUDIT (Y)^ADM||N||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20010101||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||NONE^None||||||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 WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
OBX|8|TX|INS OPC^Other Province Health Care Number^INS||123456789||||||F
GT1|1||ADMSTENTAN^HARSHA^VICKY||9866 MAPLE HILL DR^^EDMONTON^AB^T5P 3B5||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

