MSH|^~\&|ADM|SMH|||201912090851||ADT^A03|4125672|D|2.2|||AL|NE
EVN|A03|201912090851||||201912090851
PID|1|FHATVIG0012715|SM00047102|SM46881|CWFOSTER^INTRIGUE^TRAIN|O'NEIL|19870711|F|||7709 11 ST^^PORT COQUITLAM^BC^V2I 7D0|||||||SM003746/19|9874794646
PV1|1|I|SM-S2FBU2^SMFBU2-217^A|UE|||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN||||||||||||||||||DISCHARGED WITH APPROVAL|||SMH|||||201912051255|201912090851
PV2||W^Ward|LABOR
OBX|1|CE|ADM ACC VE^Requested Accommodation Verified?^ADM||Y^YES VERIF PA NOT SIGNED||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20181101||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|7|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST, EDMONTON, AB, T0L 2T0||||||F
OBX|8|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|9|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||F
OBX|10|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|11|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

