MSH|^~\&|ADM|SMH|||201911210850||ADT^A08|4109478|D|2.2|||AL|NE
EVN|A08|201911210850||||201911121415
PID|1|FHATVIG0009363|SM00044830|SM44636|ADMBAILEY^PASSPORT^TRAIN|JANE|19820107|F|||8580 54 ST^^PORT COQUITLAM^BC^V3B 7K4|||||||SM002469/19|9875321029
PV1|1|O|SM.DIAB||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201911121415|
PV2|||DIABETES
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190530||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|3|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|4|TX|INS OPCAD1^Address line 1^INS||123 LIVEHEREBEFORE ST||||||F
OBX|5|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|6|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
GT1|1||ADMBAILEY^PASSPORT^TRAIN||8580 54 ST^^PORT COQUITLAM^BC^V0D 1R4||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

MSH|^~\&|ADM|SMH|||201911210851||ADT^A08|4109483|D|2.2|||AL|NE
EVN|A08|201911210851||||201911121530
PID|1|FHATVIG0009483|SM00044883|SM44689|CWSROSS^BONNEVILLE^TRAIN|JANET|19801020|F|||4871 235 ST^^MAPLE RIDGE^BC^V1Z 1Y5|||||||SM002467/19|9875310248
PV1|1|O|SM.DIAB||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201911121530|
PV2|||DIABETES
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190604||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|3|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST.,EDMONTON AB  T1A4R4||||||F
OBX|4|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|5|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHERBEFORE ST||||||F
OBX|6|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|7|TX|INS OPCAD5^Postal Code^INS||T1A4R4||||||F
GT1|1||CWSROSS^BONNEVILLE^TRAIN||4871 235 ST^^MAPLE RIDGE^BC^V1Z 1Y5||||||SP
ZFD|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|123 ROAD^^SURREY^BC^V2V 0A0|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

