MSH|^~\&|ADM|SMH|||201912181225||ADT^A04|4130982|D|2.2|||AL|NE
EVN|A04|201912181225||||201912181221
PID|1|FHATVIG0012821|SM00047154|SM46930|ADMWILLIAMS^OUTLANDER^TRAIN|PAIGE|19420110|F|||8600 54 ST^^MAPLE RIDGE^BC^V6C 0F8|||||||SM003809/19|
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201912181221|
PV2|||WCB-LAB TEST
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||ONID^Other (No Photo ID)||||||F
OBX|2|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||B||||||F
OBX|3|TX|INS WCBBP^Body Part^INS||43230||||||F
OBX|4|TX|INS WCBDOI^Date of Injury^INS||20191218||||||F
OBX|5|TX|INS WCBNOI^Nature of Injury^INS||03700||||||F
GT1|1||ADMWILLIAMS^OUTLANDER^TRAIN||8600 54 ST^^MAPLE RIDGE^BC^V6C 0F8||||||SP
ZFD|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|123 ROAD^^SURREY^BC^V2V 0A0|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC||#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED||||||

