MSH|^~\&|ADM|LMH|||202002051445||ADT^A13|4162628|D|2.2|||AL|NE
EVN|A13|202002051445||||201905162012
PID|1|FHATVIG0008898|LM00005191|SM44479|STENBUBA^ADO|RAMATU|19840214|M|||123 ALBERT^^CALGARY^AB^A3W A3E |||||||LM000166/19|9875375124
PV1|1|E|LM.ER||||.ERGP^Generic^ER^Physician^^^^^^^^^XX|||||||||||ER|||||||||||||||||||||LMH|||||201905161939|
PV2|||TWISTED ANKLE
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190516||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||ONID^Other (No Photo ID)||||||F
OBX|3|TX|ADM LOCRES^Local Address (if visiting)^ADM||123 ADE ST,SURREY||||||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 PHONE#^Local Phone Number (if visiting)^ADM||23622334567||||||F
OBX|8|TX|UPI ISO^^ADM||CAN||||||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||123456||||||F
OBX|11|TX|INS OPC ED^OPC Expiry Date (If Applicable)^INS||20221215||||||F
OBX|12|TX|INS OPCRBC^Reason patient in British Columbia^INS||1||||||F
GT1|1||STENBUBA^ADO||123 ALBERT^^CALGARY^AB^A3W A3E ||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||.ERGP^Generic^ER^Physician^^^^^OTH|
ZFH|LUMED|||||||||UNDODEPER

