MSH|^~\&|ADM|SMH|||201912040908||ADT^A02|4123017|D|2.2|||AL|NE
EVN|A02|201912040908||||201912040908
PID|1|FHATVIG0012613|SM00047041|SM46822|PHATEST^LUMED3||19790801|M|||13750 96 Avenue^^Surrey^BC^V3V 1Z2|||||||SM003651/19|
PV1|1|I|SM-3E^SM3E-307^A|EL||SM-3E^SM3E-312^A|ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||MEDS||||||||IN|||||||||||||||||||||SMH|||||201911271414|
PV2||S^Semi-Private - Non-Solicited|
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20141112||||||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||||||

