MSH|^~\&|ADM|SMH|||201911121419||ADT^A04|4103857|D|2.2|||AL|NE
EVN|A04|201911121419||||201911121418
PID|1|FHATVIG0012389|SM00046904|SM46690|CWSBENNETT^FRONTIER^TRAIN||19280615|M|||2834 368 AVE^^MAPLE RIDGE^BC^V2D 1U1|||||||SM003468/19|9874890493
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||SMH|||||201911121418|
PV2|||CHEST X-RAY
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|2|TX|UPI ISO^^ADM||CAN||||||F
OBX|3|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|4|TX|INS FAS^Client ID Number^INS||123456||||||F
GT1|1||CWSBENNETT^FRONTIER^TRAIN||2834 368 AVE^^MAPLE RIDGE^BC^V2D 1U1||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

