MSH|^~\&|ADM|SMH|||201911191136||ADT^A11|4107572|D|2.2|||AL|NE
EVN|A11|201911191136||||20191119
PID|1|FHATVIG0000748|SM00046971|RM3021|CPATEST^COW^TEST||19700101|M|||22237 LOUGHEED HWY^^MAPLE RIDGE^BC^V0M 1V0|||||||SM003551/19|9876487213
PV1|1|I||EL|||ORMDOC^ORMDOC^TESTSURG^^^^^^^^^^XX|||SURG||||||||IN|||||||||||||||||||||SMH|||||201911190830|
PV2|||
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20151208||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||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 WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
ZFD|OEDOCM^Oedoc^Marytrain^^^^MD^50003^DOC|9876 Main Street^^Surrey^BC^V3V 1Z1|||ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|ORMDOC^ORMDOC^TESTSURG^^^^^123456^DOC|
ZFH|LUMED||||||

