MSH|^~\&|ADM|SMH|||201912181239||ADT^A04|4131006|D|2.2|||AL|NE
EVN|A04|201912181239||||201912181238
PID|1|FHATVIG0012823|SM00047155|SM46931|ADMCOX^TUNDRA^TRAIN|PAIGE|19350509|F|||7606 4 ST^^NORTH VANCOUVER^BC^V7W 3K2|||||||SM003810/19|
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||SMH|||||201912181238|
PV2|||BLOOD WORK
OBX|1|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|2|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|3|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|4|TX|INS OPCAD1^Address line 1^INS||123 LIVE HERE BEFORE ST||||||F
OBX|5|TX|INS OPCAD2^Address line 2^INS||||||||F
OBX|6|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|7|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|8|TX|INS OPCAD5^Postal Code^INS||T0L2T0||||||F
OBX|9|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||ADMCOX^TUNDRA^TRAIN||7606 4 ST^^NORTH VANCOUVER^BC^V7W 3K2||||||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||||||

