MSH|^~\&|ADM|SMH|||201912171006||ADT^A08|4130170|D|2.2|||AL|NE
EVN|A08|201912171006||||
PID|1|FHATVIG0012663|SM00047084|SM46864|PHATEST^LUMED4||19791101|M|||13750 96 AVE^^SURREY^BC^V3V 1Z2|||||||SM003698/19|
PV1|1|I|SM-3W^SM3W-326^A|EL|||ZTEST^Test Provider^IM/IT^Use Only^^^^^^^^^XX|||MEDS||||||||IN|||||||||||||||||||||SMH|||||201911281553|
PV2||S^Semi-Private - Non-Solicited|
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20121120||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||BCSWP^BC Services With Photo||||||F
OBX|3|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|4|CE|ADM MDRO4^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
AL1|1|DA|F001000476^Penicillins||ANAPHYLAXIS|20191217
ZFD|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC||||ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|ZTEST^Test Provider^IM/IT^Use Only^^^^500001^DOC|
ZFH|LUMED||||||

