MSH|^~\&|ADM|SMH|||201912021334||ADT^A08|4121882|D|2.2|||AL|NE
EVN|A08|201912021334||||201911260913
PID|1|FHATVIG0010373|SM00045399|SM45196|ADMSANCHEZ^FIERO^TRAIN|JANE|19870209|F|||3304 37 ST^^PORT COQUITLAM^BC^V3B 7K4|||||||SM002466/19|9875193192
PV1|1|O|SM.DIAB||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201911260913|
PV2|||DIABETES
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190601||||||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, T0L 2TD||||||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 LIVEDHEREBEFOREST||||||F
OBX|6|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|7|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
GT1|1||ADMSANCHEZ^FIERO^TRAIN||3304 37 ST^^PORT COQUITLAM^BC^V5I 3I8||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

