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EVN|A06|200701100250||01||200701102300
PID|||191919^^^GOOD HEALTH HOSPITAL^MR^FAC1~11111^^^USSSA^SS|253763|MASSIE^JAMES^A||19560129|M|||2222 HOME STREET^^ISHPEMING^MI^49849^""^||555-555-2004|555-555-2004||S|C|10199925^^^GOOD HEALTH HOSPITAL^AN|371-66-9256||
NK1|1|MASSIE^ELLEN|SPOUSE|2222 HOME STREET^^ISHPEMING^MI^49849^""^|555) 555 2004|555-555-5001~555-555-5001|EC1^FIRST EMERGENCY CONTACT
NK1|2|MASSIE^MARYLOU|MOTHER|300 ZOBERLEIN^^ISHPEMING^MI^49849^""^|555) 555 2004|555-555-5001~555-555-5001|EC2^SECOND EMERGENCY CONTACT
NK1|3
NK1|4|||6666 WORKER LOOP^^ISHPEMING^MI^49849^""^||(900)545-1200|EM^EMPLOYER|19940605||PROGRAMMER|||WORK IS FUN, INC.
PV1||I|6N^1234^A^GOOD HEALTH HOSPITAL||||0100^SENDER,SAM|0148^ATTEND^AARON^A||SUR|||||||0148^SENDER,SAM|S|1400|A|||||||||||||||||||GOOD HEALTH HOSPITAL|||||199501102300|
OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F
OBX||ST|1010.1^HEIGHT||190|cm|||||F
DG1|1|19||BIOPSY||00
GT1|1||EVERYMAN^ADAM^A||2222 HOME STREET^^ISHPEMING^MI^49849^""^|444-33 3333|555-555-2004||||SE^SELF|444-33 3333||||AUTO CLINIC|2222 HOME STREET^^ISHPEMING^MI^49849^""|555-555-2004
IN1|0|0|UA1|UARE INSURED, INC.|8888 INSURERS CIRCLE^^ISHPEMING^M149849^""^||555-555-3015|90||||||50
IN1|2|""|""