MSH|^~\&|ADM|SMH|||202001281351||ADT^A04|4157485|D|2.2|||AL|NE
EVN|A04|202001281351||||202001281351
PID|1|FHATVIG0013165|SM00047307|SM47082|CWSROBINSON^DASHER^TRAIN||19940312|M|||1922 142 AVE^^NORTH VANCOUVER^BC^V0V 6C0|||||||SM004048/19|
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||SMH|||||202001281351|
PV2|||BW
OBX|1|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|2|TX|INS OPC^Other Province Health Care Number^INS||1234||||||F
OBX|3|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHERBEFORE ST||||||F
OBX|4|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|5|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|6|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
OBX|7|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||CWSROBINSON^DASHER^TRAIN||1922 142 AVE^^NORTH VANCOUVER^BC^V0V 6C0||||||SP
ZFD|#WCMG^Group^#West^Coast Medical^^^^^LOCATION|3 - 3238 King George Blvd.^^Surrey^BC^V4P 1A5|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED|||||||||ENREGCLI

