MSH|^~\&|ADM|FCC|||201911011221||ADT^A04|4095976|D|2.2|||AL|NE
EVN|A04|201911011221||||201911011221
PID|1|FHATVIG0010844|FB00000528|SM45493|ITSTEST^BALVINDER||19600101|M|||15234 123 ST^^SURREY^BC^V3S 3L6|||||||FB000006/19|9875075246
PV1|1|O|FB.ADP||||ITSTESTCA2^ITSTEST^CA^FAM^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||FCC|||||201911011221|
PV2|||
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||19600101||||||F
OBX|2|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
ZFD|||||ITSTESTCA2^ITSTEST^CA^FAM^^^^^DOC|
ZFH|LUMED||||||

