MSH|^~\&|ADM|SMH|||201912121146||ADT^A04|4128173|D|2.2|||AL|NE
EVN|A04|201912121146||||201912121145
PID|1|FHATVIG0012777|SM00047132|SM46910|ADMHOWARD^SKYLARK^TRAIN|JANE|19850409|F|||4549 55 ST^^PITT MEADOWS^BC^V3R 7X5|||||||SM003777/19|9874779066
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201912121145|
PV2|||WCB IV-THERAPY
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|2|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|3|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|5|TX|ADM SCH DT^Appointment Date^ADM||||||||F
OBX|6|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||L||||||F
OBX|7|TX|INS WCBBP^Body Part^INS||43230||||||F
OBX|8|TX|INS WCBDOI^Date of Injury^INS||20191212||||||F
OBX|9|TX|INS WCBID^WCB Claim Number^INS||12345678||||||F
OBX|10|TX|INS WCBNOI^Nature of Injury^INS||03700||||||F
OBX|11|TX|INS WSBC^Is this a WorkSafeBC claim?^INS||Y||||||F
GT1|1||ADMHOWARD^SKYLARK^TRAIN||4549 55 ST^^PITT MEADOWS^BC^V3R 7X5||||||SP
ZFD|GENPT^GENP^TEST^A^^^^0008^DOC|10 SOME STREET^^NEW WESTMINSTER^BC^V3H 4N5|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC||#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED||||||

MSH|^~\&|ADM|SMH|||201912121146||ADT^A04|4128174|D|2.2|||AL|NE
EVN|A04|201912121146||||201912121145
PID|1|FHATVIG0012778|SM00047133|SM46911|CWSBUTLER^ACCLAIM^TRAIN|JULIE|19280922|F|||9447 173 AVE^^MAPLE RIDGE^BC^V7K 1A0|||||||SM003778/19|9874779059
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201912121145|
PV2|||WCB IV THERAPY
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|2|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|3|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|5|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||L||||||F
OBX|6|TX|INS WCBBP^Body Part^INS||43230||||||F
OBX|7|TX|INS WCBDOI^Date of Injury^INS||20191212||||||F
OBX|8|TX|INS WCBID^WCB Claim Number^INS||12345678||||||F
OBX|9|TX|INS WCBNOI^Nature of Injury^INS||03700||||||F
OBX|10|TX|INS WSBC^Is this a WorkSafeBC claim?^INS||||||||F
GT1|1||CWSBUTLER^ACCLAIM^TRAIN||9447 173 AVE^^MAPLE RIDGE^BC^V7K 1A0||||||SP
ZFD|GENPT^GENP^TEST^A^^^^0008^DOC|10 SOME STREET^^NEW WESTMINSTER^BC^V3H 4N5|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC||#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED||||||

