MSH|^~\&|ADM|SMH|||202002061332||ADT^A06|4163335|D|2.2|||AL|NE
EVN|A06|202002061332||||202002061329
PID|1|FHATVIG0013232|SM00047335|SM47110|ADMPERRY^VISION^TRAIN|GOOFY|19850501|F|||3939 212 AVE^^NORTH VANCOUVER^BC^V2I 3W3|||||||SM004093/19|9874750573
PV1|1|I|SM-S2FBU2^SMFBU2-221^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202002061329|
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||20191208||||||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 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||ADMPERRY^VISION^TRAIN||3939 212 AVE^^NORTH VANCOUVER^BC^V2I 3W3||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED|||||||||ENADMIN

MSH|^~\&|ADM|SMH|||202002061332||ADT^A06|4163336|D|2.2|||AL|NE
EVN|A06|202002061332||||202002061329
PID|1|FHATVIG0013230|SM00047333|SM47108|CWSPHILLIPS^REGENCY^TRAIN|BOB|19870103|F|||9769 165 AVE^^MAPLE RIDGE^BC^V3F 8U2|||||||SM004091/19|9874750606
PV1|1|I|SM-S2FBU2^SMFBU2-213^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202002061329|
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||20200101||||||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 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||CWSPHILLIPS^REGENCY^TRAIN||9769 165 AVE^^MAPLE RIDGE^BC^V3F 8U2||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED|||||||||ENADMIN

MSH|^~\&|ADM|SMH|||202002061332||ADT^A06|4163337|D|2.2|||AL|NE
EVN|A06|202002061332||||202002061329
PID|1|FHATVIG0013231|SM00047334|SM47109|ADMPOWELL^ESCALADE^TRAIN|BOBBI|19920906|F|||1827 102 ST^^ NORTH VANCOUVER^BC^V2W 1S2|||||||SM004092/19|9874750598
PV1|1|I|SM-S2FBU1^SMFBU1-203^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202002061329|
PV2||W^Ward|LABOUR
OBX|1|TX|AD LTC^Cont.Care #:^ADM||123||||||F
OBX|2|CE|ADM ACC VE^Requested Accommodation Verified?^ADM||Y^YES VERIF PA NOT SIGNED||||||F
OBX|3|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20191208||||||F
OBX|4|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|5|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|7|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|8|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 lIVEDHEREBEFORE EDMONTON, AB, T0L 2T0||||||F
OBX|9|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|10|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|11|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHERE BEFORE STRE||||||F
OBX|12|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|13|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|14|TX|INS OPCAD5^Postal Code^INS||TOL1T0||||||F
OBX|15|TX|INS OPCRBC^Reason patient in British Columbia^INS||5||||||F
GT1|1||ADMPOWELL^ESCLADAE^TRAIN||1827 102 ST^^ NORTH VANCOUVER^BC^V2W 1S2||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED|||||||||ENADMIN

