MSH|^~\&|ADM|SMH|||201910092058||ADT^A06|4073740|D|2.2|||AL|NE
EVN|A06|201910092058||||201910090150
PID|1|FHATVIG0011693|SM00046408|SM46200|ADMSTENWED^DARRYL|HARSHA|19880228|M|||76-7166 DELI LANE^^SURREY^BC^V3X 2C2|||||||SM002801/19|
PV1|1|I|SM-ERTAC1^SMERTAC1^AB|UE||SM.ERT|SWANSONT^Swanson^Todd^^^^^^^^^^XX|||EMED||||||||IN|||||||||||||||||||||SMH|||||201910090150|
PV2||W^Ward|RIGHT HIP FRACTURED
OBX|1|TX|ADM AC AUD^HIGH PROFILE PATIENT - ACCESS AUDIT (Y)^ADM||N||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20111215||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||NONE^None||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|7|CE|ADM TPL^Third Party Liability?^ADM||N^No||||||F
OBX|8|TX|INS WCBAP^Anatomical Positions (Side of Body)^INS||R||||||F
OBX|9|TX|INS WCBBP^Body Part^INS||25100||||||F
OBX|10|TX|INS WCBDOI^Date of Injury^INS||20191009||||||F
OBX|11|TX|INS WCBNOI^Nature of Injury^INS||99990||||||F
OBX|12|CE|INS WSBC^Is this a WorkSafeBC claim?^INS||Y^Yes||||||F
GT1|1||ADMSTENWED^DARRYL||76-7166 DELI LANE^^SURREY^BC^V3X 2C2||||||SP
ZFD|BOXERJ^Boxer^Jacob^^^^^00458^DOC|1530 West 7th Avenue^Seymour Health Centre^Vancouver^BC^V6J 1S3|.ERGP^Generic^ER^Physician^^^^^OTH||SWANSONT^Swanson^Todd^^^^^64932^DOC|SWANSONT^Swanson^Todd^^^^^64932^DOC|#WBC^BC^#Worksafe^^^^^^LOCATION|
ZFH|LUMED|201910090130|2||||

