MSH|^~\&|ADM|SMH|||202001081124||ADT^A08|4141974|D|2.2|||AL|NE
EVN|A08|202001081124||||201912230800
PID|1|FHATVIG0009363|SM00044830|SM44636|ADMBAILEY^PASSPORT^TRAIN|JANE|19820107|F|||8580 54 ST^^PORT COQUITLAM^BC^V3B 7K4|||||||SM002469/19|9875321029
PV1|1|O|SM.DIAB||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^^^^^^XX|||||||||||RCR|||||||||||||||||||||SMH|||||201912230800|
PV2|||DIABETES
OBX|1|TX|ADM CURRES^Residing at current add. since (DD/MM/YY)^ADM||20190530||||||F
OBX|2|CE|ADM IDSOUR^SOURCE OF ID^ADM||OPID^Other Photo ID||||||F
OBX|3|TX|ADM WCB^IS THIS VISIT RELATED TO A WCB CLAIM?^INS||N||||||F
OBX|4|TX|INS OPCAD1^Address line 1^INS||123 LIVEHEREBEFORE ST||||||F
OBX|5|TX|INS OPCAD3^City^INS||EDMONTON||||||F
OBX|6|TX|INS OPCAD5^Postal Code^INS||T0L1T0||||||F
GT1|1||ADMBAILEY^PASSPORT^TRAIN||8580 54 ST^^PORT COQUITLAM^BC^V0D 1R4||||||SP
ZFD|.UNATTACH^Unattach^^^^^^^OTH||||SEUSST^SEUSS *TEST^THEODORE^*TEST* G^^^^12^DOC|
ZFH|LUMED||||||