MSH|^~\&|ADM|SMH|||201911071951||ADT^A04|4102786|D|2.2|||AL|NE
EVN|A04|201911071951||||201911071949
PID|1|FHATVIG0006097|SM00043008|SM42879|ADMSANCHEZ^BRONCO^TRAIN|MARY|19550101|F|||5656 BUBBLE AVE^^EDMONTON^BC^T5F 7M9|||||||SM003456/19|9875794695
PV1|1|O|SM.SDC||||.UNATTACH^Unattach^^^^^^^^^^^XX|||||||||||SDC|||||||||||||||||||||SMH|||||201911071949|
PV2|||
OBX|1|TX|ADM AC AUD^HIGH PROFILE PATIENT - ACCESS AUDIT (Y)^ADM||N||||||F
OBX|2|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20010101||||||F
OBX|3|CE|ADM IDSOUR^SOURCE OF ID^ADM||ONID^Other (No Photo ID)||||||F
OBX|4|CE|ADM MDRO2^Canada in the last 12 months?^ADM||N^NO||||||F
OBX|5|CE|ADM MDRO4^or Bangladesh in the last 12 months?^ADM||N^NO||||||F
OBX|6|TX|ADM MN^Enter Patient's Maiden Name:^ADM||ADMSANCHEZ||||||F
OBX|7|CE|ADM MRSA2^correctional/shelter in the last 6 months?^ADM||N^NO||||||F
OBX|8|CE|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N^NO||||||F
GT1|1||ADMSANCHEZ^BRONCO^TRAIN||5656 BUBBLE AVE^^EDMONTON^BC^T5F 7M9||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||.UNATTACH^Unattach^^^^^^^OTH|
ZFH|LUMED||||||