MSH|^~\&|ADM|SMH|||201911191000||ADT^A05|4107400|D|2.2|||AL|NE
EVN|A05|201911191000||||201911190830
PID|1|FHATVIG0000748|SM00046971|RM3021|CPATEST^COW^TEST||19700101|M|||22237 LOUGHEED HWY^^MAPLE RIDGE^BC^V0M 1V0|||||||SM003551/19|9876487213
PV1|1|P|SM.OR||||ORMDOC^ORMDOC^TESTSURG^^^^^^^^^^XX|||||||||||SDC|||||||||||||||||||||SMH|||||201911190830|
PV2|||
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20151208||||||F
OBX|2|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|OEDOCM^Oedoc^Marytrain^^^^MD^50003^DOC|9876 Main Street^^Surrey^BC^V3V 1Z1|||ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|
ZFH|LUMED||||||

