MSH|^~\&|ADM|SMH|||201911281601||ADT^A01|4117189|D|2.2|||AL|NE
EVN|A01|201911281601||||201911281559
PID|1|FHATVIG0012664|SM00047085|SM46865|PHATEST^LUMED7||19690701|M|||13750 96 AVE^^SURREY^BC^V3V 1Z2|||||||SM003699/19|
PV1|1|I|SM-T71^SMT71-01^1|EL|||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||NEPH||||||||IN|||||||||||||||||||||SMH|||||201911281559|
PV2||P^Private - Non-Solicited|
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20141119||||||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 WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
ZFD|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

