MSH|^~\&|ADM|ARH|||201912181210||ADT^A03|4130943|D|2.2|||AL|NE
EVN|A03|20191218||||
PID|1|FHATVIG0012702|AB00008384|AB8303|UCIINS^TESTP||19850423|F|||100-25 APPLE PL^^SURREY^BC^V5X 3N3|||||||AB000729/19|9874798571
PV1|1|O|AB.BH||||GENPT^GENP^TEST^A^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||ARH|||||201912031256|
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|2|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||N||||||F
OBX|3|TX|INS WCBBP^Body Part^INS||22800||||||F
OBX|4|TX|INS WCBNOI^Nature of Injury^INS||03400||||||F
ZFD|DOCT^DOC^TEST^A^^^^0006^DOC|10 NOW STREET^^ABBOTSFORD^BC^V4H 5N6|||GENPT^GENP^TEST^A^^^^0008^DOC|
ZFH|LUMED||||||

MSH|^~\&|ADM|ARH|||201912181210||ADT^A03|4130944|D|2.2|||AL|NE
EVN|A03|201912181210||||201912181200
PID|1|FHATVIG0012702|AB00008384|AB8303|UCIINS^TESTP||19850423|F|||100-25 APPLE PL^^SURREY^BC^V5X 3N3|||||||AB000729/19|9874798571
PV1|1|O|AB.BH||||GENPT^GENP^TEST^A^^^^^^^^^XX|||||||||||CLI||||||||||||||||||DISCHARGED WITH APPROVAL|||ARH|||||201912031256|201912181200
PV2|||
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|2|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||N||||||F
OBX|3|TX|INS WCBBP^Body Part^INS||22800||||||F
OBX|4|TX|INS WCBNOI^Nature of Injury^INS||03400||||||F
ZFD|DOCT^DOC^TEST^A^^^^0006^DOC|10 NOW STREET^^ABBOTSFORD^BC^V4H 5N6|||GENPT^GENP^TEST^A^^^^0008^DOC|
ZFH|LUMED||||||

