MSH|^~\&|ADM|SMH|||202001231310||ADT^A06|4153277|D|2.2|||AL|NE
EVN|A06|202001231310||||202001231307
PID|1|FHATVIG0013120|SM00047279|SM47056|CWSPARKER^FESTIVE^TRAIN|BARB|19850525|F|||4978 212 AVE^^PITT MEADOWS^BC^V1C 5I4|||||||SM004012/19|9874753371
PV1|1|I|SM-S2FBU1^SMFBU1-208^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001231307|
PV2||W^Ward|LABOUR
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||20200116||||||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 T0L 2T0||||||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||12345000||||||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||CWSPARKER^FESTIVE^TRAIN||4978 212 AVE^^PITT MEADOWS^BC^V1C 5I4||||||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|||202001231310||ADT^A06|4153278|D|2.2|||AL|NE
EVN|A06|202001231310||||202001231307
PID|1|FHATVIG0013118|SM00047277|SM47054|ADMPHILLIPS^SUMMIT^TRAIN|SHARON|19910803|F|||1559 173 AVE^^NORTH VANCOUVER^BC^V4L 6H3|||||||SM004010/19|9874753396
PV1|1|I|SM-S2FBU2^SMFBU2-211^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001231307|
PV2||W^Ward|LABOUR
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||20200116||||||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 LIVEDHERBEFORE ST, EDMONTON, AB, T0L 2T0||||||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 LIVED HERE BEFORE 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||ADMPHILLIPS^SUMMIT^TRAIN||1559 173 AVE^^NORTH VANCOUVER^BC^V4L 6H3||||||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|||202001231310||ADT^A06|4153279|D|2.2|||AL|NE
EVN|A06|202001231310||||202001231307
PID|1|FHATVIG0013119|SM00047278|SM47055|ADMGREEN^ACCLAIM^TRAIN|SIMPSON|19960118|F|||8026 112 ST^^PITT MEADOWS^BC^v7a 6x3|||||||SM004011/19|9874753389
PV1|1|I|SM-S2FBU2^SMFBU2-213^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001231307|
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||20200116||||||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, T0L 2T0||||||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 LIVED HERE BEFORE 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||T01T10||||||F
OBX|14|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||ADMGREEN^ACCLAIM^TRAIN||8026 112 ST^^PITT MEADOWS^BC^v7a 6x3||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

