MSH|^~\&|ADM|SMH|||202001021254||ADT^A06|4137662|D|2.2|||AL|NE
EVN|A06|202001021254||||202001021252
PID|1|FHATVIG0012891|SM00047180|SM46959|ADMCAMPBELL^EXPRESS^TRAIN||19860413|F|||6688 109 ST NEW WESTMINSTER^^NEW WESTMINSTER^BC^V3X6Z3|||||||SM003855/19|9874762879
PV1|1|I|SM-S2FBU1^SMFBU1-208^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001021252|
PV2||W^Ward|LABOR
OBX|1|CE|ADM ACC VE^Requested Accommodation Verified?^ADM||Y^YES VERIF PA NOT SIGNED||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20181101||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|7|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST, EDMONTON, AB, T0L2T0||||||F
OBX|8|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|9|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|10|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||F
OBX|11|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|12|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|13|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
OBX|14|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||ADMCAMPBELL^EXPRESS^TRAIN||6688 109 ST NEW WESTMINSTER^^NEW WESTMINSTER^BC^V3X6Z3||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

MSH|^~\&|ADM|SMH|||202001021254||ADT^A06|4137663|D|2.2|||AL|NE
EVN|A06|202001021254||||202001021252
PID|1|FHATVIG0012892|SM00047181|SM46960|ADMGRIFFIN^LAGONDA^TRAIN||19910308|F|||9882 94 ST^^PORT COQUITLAM^BC^V3Y 4U4|||||||SM003856/19|9874762861
PV1|1|I|SM-S2FBU1^SMFBU1-203^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001021252|
PV2||W^Ward|LABOR
OBX|1|CE|ADM ACC VE^Requested Accommodation Verified?^ADM||Y^YES VERIF PA NOT SIGNED||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20191226||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|7|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST,EDMONTON,AB,T0L2T0||||||F
OBX|8|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|9|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|10|TX|INS OPCAD1^Address line 1^INS||123 LIVEHEREBEFORE ST||||||F
OBX|11|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|12|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|13|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
OBX|14|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||ADMGRIFFIN^LAGONDA^TRAIN||9882 94 ST^^PORT COQUITLAM^BC^V3Y 4U4||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

