MSH|^~\&|ADM|SMH|||202001211518||ADT^A04|4151300|D|2.2|||AL|NE
EVN|A04|202001211518||||202001211517
PID|1|FHATVIG0013089|SM00047268|SM47045|CWSJENKINS^ROADSTER^TRAIN|FILIP|19360713|M|||1873 125 ST EDMONTON^^EDMONTON^AB^T0Z 4I3|||||||SM003996/19|
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||SMH|||||202001211517|
PV2|||DOPPLER ULTRASOUND
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 OPC ED^OPC Expiry Date (If Applicable)^INS||20201105||||||F
OBX|5|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||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||T0L1T0||||||F
OBX|9|TX|INS OPCRBC^Reason patient in British Columbia^INS||1||||||F
GT1|1||CWSJENKINS^ROADSTER^TRAIN||1873 125 ST EDMONTON^^EDMONTON^AB^T0Z 4I3||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

MSH|^~\&|ADM|SMH|||202001211518||ADT^A04|4151304|D|2.2|||AL|NE
EVN|A04|202001211518||||202001211517
PID|1|FHATVIG0013090|SM00047269|SM47046|ADMSCOTT^TIBURON^TRAIN|TRACY|19490618|M|||1201 172 ST^^EDMONTON^AB^T0R 0G1|||||||SM003997/19|
PV1|1|O|SM.TRAIN||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||CLI|||||||||||||||||||||SMH|||||202001211517|
PV2|||DOPPLER ULTRASOUND
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 LIVEDHEREBEFORE ST||||||F
OBX|5|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|6|TX|INS OPCAD4^Province^INS||AB||||||F
OBX|7|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
OBX|8|TX|INS OPCRBC^Reason patient in British Columbia^INS||1||||||F
GT1|1||ADMSCOTT^TIBURON^TRAIN||1201 172 ST^^EDMONTON^AB^T0R 0G1||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||

