MSH|^~\&|ADM|SMH|||202002031106||ADT^A08|4160049|D|2.2|||AL|NE
EVN|A08|202002031106||||202001211315
PID|1|FHATVIG0010377|SM00045406|SM45203|ADMRAMIREZ^CORVETTE^TRAIN|MINNIE|19910707|F|||9896 219 AVE^^PORT COQUITLAM^BC^V4W 7T8|||||||SM002463/19|9875193139
PV1|1|O|SM.DIAB||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||202001211315|
PV2|||DIABETES
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190601||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||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|TX|ADM PRERE^Previous Address if less than 6 months at current^ADM||123 LIVEDHEREBEFORE ST, EDMONTON, AB TOL 2T0||||||F
OBX|7|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|8|TX|INS OPCAD1^Address line 1^INS||123 LIVEDHEREBEFORE ST||||||F
OBX|9|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|10|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
GT1|1||ADMRAMIREZ^CORVETTE^TRAIN||9896 219 AVE^^PORT COQUITLAM^BC^V4W 7T8||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED|||||||||EDREGRCR

