MSH|^~\&|ADM|RCH|||201912031459||ADT^A05|4122761|D|2.2|||AL|NE
EVN|A05|201912031459||||201912031515
PID|1|FHATVIG0005261|RC00007948|LM4671|CPATEST^OCARINA^TEST||19740907|M|||666666 SIX STREET^^LANGLEY^BC|||||||RC000872/19|9875846256
PV1|1|P|RC-T4S||||ORMDOC^ORMDOC^TESTSURG^^^^^^^^^^XX|||ORTH||||||||IN|||||||||||||||||||||RCH|||||201912031515|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
AL1|1|FA|COTTAGECHEESE^Cottage Cheese|MI|GI Intolerance        ADR|20180907
AL1|2|DA|F006002380^naproxen|MO|Headache              ADR|20180907
AL1|3|DA|F006004787^diphenhydramine^^From Benadryl Allergy|MO|Tachycardia           ADR|20180907
AL1|4|FA|F006008128^radish|MI|Hives/Urticaria       *AL|20180907
AL1|5|FA|F006010014^apricot|MI|Dizziness             ADR|20180907
ZFD|OEDOCM^Oedoc^Marytrain^^^^MD^50003^DOC|9876 Main Street^^Surrey^BC^V3V 1Z1|||ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|
ZFH|LUMED||||||

