MSH|^~\&|ADM|SMH|||201911011256||ADT^A04|4095995|D|2.2|||AL|NE
EVN|A04|201911011256||||201911011256
PID|1|FHATVIG0006405|SM00043243|SM43113|PHATEST^IOAT||19801025|M|||2828 TEST^^SURREY^BC^V5E 0A1|||||||SM003372/19|
PV1|1|O|SM.IOAT||||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201911011256|
PV2|||
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||NONE^None||||||F
OBX|2|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|3|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|5|TX|UPI ISO^^ADM||CAN||||||F
OBX|6|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
AL1|1|MA| NKDA^No Known Drug Allergies.|||20181025
ZFD|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

