MSH|^~\&|ADM|LMH|||201905311753||ADT^A12|3959129|D|2.2|||AL|NE
EVN|A12|201905311753||||201905311700
PID|1|FHATVIG0009426|LM00005334|LM5184|ADMTESTOR^SYDNEY^JANE|TRISHA|19981202|F|||5310 NIPTUCK RD^^FORT LANGLEY^BC^V3X 5P4|||||||LM000419/19|
PV1|1|I|LM-2N^LM2N-230^4|UE|||COWIES^Cowie^Scott^E^^^^^^^^^XX|||SURG||||||||IN|||||||||||||||||||||LMH|||||201905301800|
PV2||W^Ward|QUERY LOWER LUMBAR INJURY
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20090531||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCSWP^BC Services With Photo||||||F
OBX|3|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|6|CE|ADM TPL^Third Party Liability?^ADM||Y^Yes||||||F
OBX|7|CE|INS WCBAP^Anatomical Positions (Side of Body)^INS||N^No||||||F
OBX|8|TX|INS WCBBP^Body Part^INS||23300||||||F
OBX|9|TX|INS WCBDOI^Date of Injury^INS||20190530||||||F
OBX|10|TX|INS WCBNOI^Nature of Injury^INS||99990||||||F
OBX|11|TX|INS WCBPOC^Province of claim:^INS||||||||F
OBX|12|CE|INS WSBC^Is this a WorkSafeBC claim?^INS||Y^Yes||||||F
ZFD|.UNATTACH^Unattach^^^^^^^OTH||.ERGP^Generic^ER^Physician^^^^^OTH||CASHG^Cash^Gold^E^^^^28111^DOC|TEST12345^TEST12345^^^^^^^DOC|#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED|201905301625|2||||
