MSH|^~\&|ADM|SMH|||201911221450||ADT^A04|4111832|D|2.2|||AL|NE
EVN|A04|201911221450||||201911221450
PID|1|FHATVIG0012508|SM00046985|SM46768|ADMKING^LIBERTE^TRAIN|PARMJIT|19920115|F|||7-7447 AVE^^PORT COQUITLAM^BC^V4K 7F2|||||||SM003618/19|9874856319
PV1|1|E|SM.ERTWIZ||||.ERGP^Generic^ER^Physician^^^^^^^^^XX|||||||||||ER|||||||||||||||||||||SMH|||||201911221450|
PV2|||SUPER SICK
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20181101||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||NONE^None||||||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|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST, EDMONTON,AB,T0L 2T0||||||F
OBX|7|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|8|TX|INS OPCAD1^Address line 1^INS||12 LIVEDHEREBEFORE ST||||||F
OBX|9|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|10|TX|INS OPCAD5^Postal Code^INS||TO1LIT||||||F
GT1|1||ADMKING^LIBERTE^TRAIN||7-7447 AVE^^PORT COQUITLAM^BC^V4K 7F2||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||.ERGP^Generic^ER^Physician^^^^^OTH|
ZFH|LUMED||||||

