MSH|^~\&|ADM|SMH|||201912191141||ADT^A04|4131779|D|2.2|||AL|NE
EVN|A04|201912191141||||201912191141
PID|1|FHATVIG0012845|SM00047161|SM46938|CWSWHITE^MAXIMA^TRAIN||19960120|M|||8756 67 AVE^^PORT COQUITLAM^BC^V2S 5Y7|||||||SM003818/19|9874768783
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201912191141|
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^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MRSA2^correctional/shelter in the last 12 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||20191219||||||F
OBX|8|TX|INS WCBID^WCB Claim Number^INS||12345678||||||F
OBX|9|TX|INS WCBNOI^Nature of Injury^INS||01200||||||F
GT1|1||CWSWHITE^MAXIMA^TRAIN||8756 67 AVE^^PORT COQUITLAM^BC^V2S 5Y7||||||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||||||

