MSH|^~\&|ADM|SMH|||202001161348||ADT^A06|4148016|D|2.2|||AL|NE
EVN|A06|202001161348||||202001161345
PID|1|FHATVIG0013038|SM00047243|SM47021|CWSGONZALES^SORENTO^TRAIN|MINNIE MOUSE|19870924|F|||6476 29 AVE^^NORTH VANCOUVER^BC^V4H 7P0|||||||SM003953/19|9874757118
PV1|1|I|SM-S2FBU2^SMFBU2-222^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001161345|
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||20200109||||||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^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 12 months?^ADM||NA^NOT ASKED||||||F
OBX|7|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST, EDMONTON, AB, T0L 2TO||||||F
OBX|8|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|9|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|10|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||F
OBX|11|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|12|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|13|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
OBX|14|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||CWSGONZALES^SORENTO^TRAIN||6476 29 AVE^^NORTH VANCOUVER^BC^V4H 7P0||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

MSH|^~\&|ADM|SMH|||202001161348||ADT^A06|4148017|D|2.2|||AL|NE
EVN|A06|202001161348||||202001161344
PID|1|FHATVIG0013037|SM00047242|SM47020|CWSLOPEZ^METRO^TRAIN|SARA|19880719|F|||5237 103 AVE^^PORT COQUITLAM^BC^V0K 6G7|||||||SM003952/19|9874757125
PV1|1|I|SM-S2FBU2^SMFBU2-221^A|UE||SM.TRAIN|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||OBS/AP||||||||IN|||||||||||||||||||||SMH|||||202001161344|
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||20200109||||||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^Bangladesh or Vietnam in the last 12 months?^ADM||N^NO||||||F
OBX|6|CE|ADM MRSA2^correctional/shelter in the last 12 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 SCH DT^Appointment Date^ADM||||||||F
OBX|9|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|10|TX|INS OPC^Other Province Health Care Number^INS||123450000||||||F
OBX|11|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||F
OBX|12|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|13|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|14|TX|INS OPCAD5^Postal Code^INS||T0LIT0||||||F
OBX|15|TX|INS OPCRBC^Reason patient in British Columbia^INS||4||||||F
GT1|1||CWSLOPEZ^METRO^TRAIN||5237 103 AVE^^PORT COQUITLAM^BC^V0K 6G7||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

