MSH|^~\&|ADM|SMH|||202001031453||ADT^A01|4138810|D|2.2|||AL|NE
EVN|A01|202001031453||||202001021853
PID|1|FHATVIG0012932|SM00047196|SM46975|SAMPLEBABY^MOTHER^TEST|BARBARA|19970605|F|||23960265 ST^^SOUTH SURREY^BC^V8X 6K6|||||||SM003876/19|
PV1|1|I|SM-S2FBU1^SMFBU1-207^A|UE|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS||||||||IN|||||||||||||||||||||SMH|||||202001021853|
PV2||W^Ward|TERM PREGNANCY
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||20180801||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCSWP^BC Services With Photo||||||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|TX|ADM MN^Enter Patient's Maiden Name:^ADM||SAMPLE,MOTHER TEST||||||F
OBX|7|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|8|CE|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
GT1|1||SAMPLEBABY^MOTHER^TEST||23960265 ST^^SOUTH SURREY^BC^V8X 6K6||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

