MSH|^~\&|ADM|ARH|||201912301120||ADT^A06|4137031|D|2.2|||AL|NE
EVN|A06|201912301120||||201912301119
PID|1|FHATVIG0012883|AB00008456|AB8354|PCSTEST^PCSREF||19391230|M|||123 Sun Drive^^Surrey^BC^V124C6|||||||AB000897/19|
PV1|1|I|AB-HHH^ABHHH-206^1|UE||AB.ER|EDMTEST^EDM Test Provider^Upgrade^^^^^^^^^^XX|||HOSP||||||||IN|||||||||||||||||||||ARH|||||201912301119|
PV2||WH^Ward Hospice|Testing PCSREF on PRE ER
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20000101||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|3|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
ZFD|EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC||EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC||EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC|EDMTEST^EDM Test Provider^Upgrade^^^^^^DOC|
ZFH|LUMED||||||

