North West Genomic Medicine Service Alliance
0.0.7 - ci-build
North West Genomic Medicine Service Alliance, published by NHS North West GMSA. This guide is not an authorized publication; it is the continuous build for version 0.0.7 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nw-gmsa/R4/ and changes regularly. See the Directory of published versions
HL7 over HTTP is preferred for this message, MLLP is also supported.
| Segment HL7 | Optionality | Notes |
|---|---|---|
| MSH | 1..1 | |
| PID | 1..1 | |
| PV1 | 0..1 | PV1 should be populated if PV1-19 Visit Number is known |
| ORDER | 1..* | |
| - ORC | 1..* | |
| - OBSERVATION REQUEST | 1..* | |
| – OBR | 1..* | |
| – NTE | 0..* | |
| – DG1 | 0..* | |
| – OBSERVATION | 0..* | |
| — OBX | 0..* | |
| - SPECIMEN | 0..* | Conditional - required for complete order |
| – SPM | 0..1 |
HL7 over HTTP is preferred for this message, MLLP is also supported.
| Segment HL7 | Optionality | Notes |
|---|---|---|
| MSH | 1..1 | |
| PID | 1..1 | |
| PV1 | 0..1 | PV1 should be populated if PV1-19 Visit Number is known |
| ORDER OBSERVATION | 1..* | |
| - ORC | 1..* | |
| - OBR | 1..* | |
| – OBSERVATION | 1..* | |
| – OBX | 1..* |
See also which are functionally equivalent and have a similar data model:
| Segment HL7 | Optionality | Notes |
|---|---|---|
| MSH | 1..1 | |
| EVN | 1..1 | |
| PID | 1..1 | |
| PV1 | 1..1 | PV1 should be populated if PV1-19 Visit Number is known |
| ORDER | 0..* | |
| - ORC | 1..1 | |
| - OBR | 1..1 | |
| TXA | 1..1 | |
| OBXNTE | 1..* | |
| - OBX | 1..1 |
This is based on the definition of MSH from NHS England HL7 v2 ADT Message Specification.
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values | ||
|---|---|---|---|---|---|---|---|
| MSH-1 | Field Separator | R | ` | ||||
| MSH-2 | Encoding Characters | R | ^~\& | ||||
| MSH-3 | Sending Application | R | iGene | ||||
| MSH-4 | Sending Facility | HD | R | ODS Code | 699X0 | ||
| MSH-5 | Receiving Application | HD | R | EPIC | |||
| MSH-6 | Receiving Facility | R | ODS Code | R0A | |||
| MSH-7 | Date/Time Of Message | R | 20170126143602 | ||||
| MSH-9 | Message Type | R | ORU^R01^ORU_R01 | ||||
| MSH-10 | Message Control ID | R | 2017012614360280000 | ||||
| MSH-11 | Processing ID | R | P | ||||
| MSH-12 | Version ID | R | 2.5.1 | ||||
| MSH-13 | Accept AcknowledgmentType | R | AL |
This is based on the definition of PID from NHS England HL7 v2 ADT Message Specification and Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| PID-1 | Set ID-PID | R | 1 | ||
| PID-3 | Patient Identifier List | CX | R | NHS Number Medical Record Number. |
633^^^R0A^MR~9449305552^^^NHS^NH |
| PID-5 | Patient Name | R | CHISLETT^Octavia^^Miss | ||
| PID-7 | Date/Time of Birth | R | 20080920 | ||
| PID-8 | Administrative Sex | R | F | ||
| PID-11 | Patient Address | R | 1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST | ||
| PID-13 | Phone Number - Home | R | 01656 123123^PRN^PH~07927655295^ORN^CP^NET^X.400^abc@home.com~01656 123123~01656123123^PRN^PH^^^abc@home.com~01656123123^PRN^PH | ||
| PID-32 | Identity Reliability Code | O | Mandatory if the the NHS Number tracing status is not known. | 01 |
PID|1||633^^^R0A^MR~9449305552^^^^NH||CHISLETT^Octavia||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
FHIR Resource Example: Patient - Octavia CHISLETT NHS Number: 9449305552
The PV1 segment should represent the episode/stay/visit number, not a consultant episode.
This is based on the definition of PV1 from NHS England HL7 v2 ADT Message Specification
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values | |
|---|---|---|---|---|---|---|
| PV1-1 | Set ID - PV1 | PL | R | 1 | ||
| PV1-3 | Assigned Patient Location | R | ^^^R0A09^^^^^^^R0A ^^^P1S8J^^^^^^^699X0 |
|||
| PV1-8 | Referring Doctor | XCN | R | Practitioner Identifier | C3456789^Darwin^Samuel^^^Dr^^^GMC | |
| PV1-10 | Hospital Service | R | Service | 311 | ||
| PV1-19 | Visit Number | CX | O - SHOULD | Hospital Provider Spell Identifier | 12345^^^R0A |
PV1|1|O|^^^R0A09^^^^^^^R0A||||C3456789^Darwin^Samuel^^^Dr^^^GMC|||100|||||||||1001166717|||||||||||||||||||||||||20250129103726+0000
FHIR Resource Example: Encounter ‘episode/stay’ Example
This is based on the definition of ORC from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide.
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| ORC-2 | Placer Order Number | EI | R | Placer Order Number | 1601737^R0A^150^L |
| ORC-3 | Filler Order Number | EI | R | Filler Order Number | 1001166717^699X0^^255^ISO |
| ORC-4 | Placer Group Number | EI | R | Placer Group Number | 1001166717^699X0^^255^ISO |
| ORC-5 | Order Status | O | |||
| ORC-9 | Date/Time of Transaction | TS | O | ||
| ORC-12 | Ordering Provider | XCN | R | Practitioner Identifier | C3456789^Darwin^Samuel^^^Dr^^^GMC |
| ORC-21 | Ordering Facility Name | XON | R | Organisation Code |
ORC|NW|1601737^R0A|1001166717^699X0||||||20250129|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||^^R0A^^^ODS
FHIR Resource Example: ServiceRequest Coded Entries Example
This is based on the definition of OBR from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values | |
|---|---|---|---|---|---|---|
| OBR-1 | Set ID - OBR | R | 1 | |||
| OBR-2 | Placer Order Number | EI | R | Placer Order Number | 1601737^ R0A^150^L | |
| OBR-3 | Filler Order Number | EI | R | Filler Order Number | 1001166717^699X0^^255^ISO | |
| OBR-4 | Universal Service Identifier | R | Genomic Test Directory | R240.1^Diagnostic testing for known variant(s)^England-GenomicTestDirectory | ||
| OBR-6 | Requested Date/Time | TS | R for OML_O21 | 20170126135745 | ||
| OBR-7 | Observation Date/Time | TS | R for ORU_R01 | 20170126135745 | ||
| OBR-16 | Ordering Provider | R | Practitioner Identifier | C3456789^Darwin^Samuel^^^Dr^^^GMC | ||
| OBR-22 | Results Rpt/Status Chng -Date/Time | TS | R | 20170126135745 | ||
| OBR-25 | Result Status | |||||
| OBR-32 | Principal Result Interpreter | NDL | O - SHOULD | DiagnosticReport.resultsInterpreter[primaryReporter] | ||
| OBR-33 | Assistant Result Interpreter | NDL | O - SHOULD | DiagnosticReport.resultsInterpreter[secondaryReporter] | ||
| OBR-34 | Technician | NDL | O - SHOULD | DiagnosticReport.performer[operator] |
OBR|1|1601737^R0A|1001166717^699X0|R240.1^^England-GenomicTestDirectory||20250129||||||||||C3456789^Darwin^Samuel^^^Dr^^^GMC
FHIR Resource Example: Diagnostic Report Example
Multiple NTE should be converted to a single FHIR Annotation using markdown
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| NTE-1 | Set ID - NTE | ||||
| NTE-2 | Source of Comment | ||||
| NTE-3 | Comment | ||||
| NTE-4 | Comment Type |
NTE|1||Referral lab PLEASE do following tests:
NTE|2||
NTE|3||Test(s) required: WGS
NTE|4||Sample type: Blood
NTE|5||Transport used: Merlin Courier
NTE|6||Tracking Number: ABC123
NTE|7||Sample sent to: LWH Genetics
NTE|8||By: PDAY on: 02/04/25
NTE|9||
NTE|10||.Speciality Requesting Clinician: PAEDS
NTE|11||Test Group: Neurology
NTE|12||Ethnic Group: White British
NTE|13||Patient is from consanguineous union? : Unknown
NTE|14||Specimen Collection Status: Collect & send with order
NTE|15||Infection Risk: No Specific Risk
NTE|16||Clinical details:
NTE|17||
NTE|18||TESTING
NTE|19||Contact/Bleep No: 123
FHIR Resource Example OML_O21: ServiceRequest Coded Entries Example
FHIR Resource Example ORU_R01: TODO
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| DG1-3 | Diagnosis Code | CE | |||
| DG1-4 | Diagnosis Description |
DG1|1||363349007^Malignant tumour of stomach^SNM3||20250129103726+0000
FHIR Resource Example ORU_R01: TODO
This is based on the definition of OBX from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| OBX-1 | Set ID – OBX | R | 1 | ||
| OBX-2 | Value Type | R | See next section for ED | CE | |
| OBX-3 | Observation Identifier | CE | R | 842009^Consanguinity^SNM3 97209-1^Shipment tracking number^LN 161714006^Estimated date of delivery^SNM3 |
|
| OBX-5 | Observation Value | Varies | R | LN^Yes^LA33-6 (value type=CE) UK3096580215 (value type=ST) 20250512103726+0000 (value type=DT) |
|
| OBX-11 | Observation Result Status | R | F | ||
| OBX-14 | Date/Time of the Observation | TS | O - SHOULD | 20190514102417+0000 |
OBX|1|CE|GENEAP^GENETICS TEST PERFORMABLE^https://nw-gmsa.github.io/CodeSystem/MFTQuestionIds|||||||||||20250129103726+0000
OBX|2|CE|230056^What Type of Referral Do You Require?^https://nw-gmsa.github.io/CodeSystem/MFTQuestionIds|||||||||||20250129103726+0000
OBX|3|CE|281269004^High infection risk sample^SNM3|||||||||||20250129103726+0000
OBX|4|ST|230016^Test Type^https://nw-gmsa.github.io/CodeSystem/MFTQuestionIds||Diagnostic Screen/Test|||||||||20250129103726+0000
FHIR Resource Example: Consanguinity (value type=CE)
FHIR Resource Example: Order Tracking Number (value type=ST)
FHIR Resource Example: Pregnancy Expected Delivery Date (value type=DT)
This is based on the definition of OBX from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| OBX-1 | Set ID – OBX | R | 1 | ||
| OBX-2 | Value Type | ED | R | ED | |
| OBX-3 | Observation Identifier | ED | R | Document Entry Type | 1054161000000101^Genetic report^SNM3 |
| OBX-5 | Observation Value | R | MOL^IM^PDF^Base64^JVBERI0X… | ||
| OBX-11 | Observation Result Status | R | F | ||
| OBX-14 | Date/Time of the Observation | O - SHOULD | 20190514102417+0000 |
OBX|1|ED|1054161000000101^Genetic report^SNM3||MOL^IM^PDF^Base64^JVBERi0x...||||||F
FHIR Resource Example: Document Reference Laboratory Report
This is based on the definition of SPM from Digital Health and Care Wales - HL7 ORU_R01 2.5.1 Implementation Guide
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| SPM-2 | Specimen ID | O | Placer Specimen Number^Filler Specimen Number | 25GEN-029GN00001&R0A | |
| SPM-3 | Specimen Parent IDs | O | ^1001166717&699X0 | ||
| SPM-4 | Specimen Type | O | Specimen Type | 119325001^Skin specimen^SNM3 | |
| SPM-8 | Specimen Source Site | O | 299706009^Bone structure of wrist and/or hand^SNM3 | ||
| SPM-9 | Specimen Source Site Modifier | O | 7771000^Left^SNM3 | ||
| SPM-17 | Specimen Collection Date/Time | TS | O | ||
| SPM-18 | Specimen Received Date/Time | TS | O | ||
| SPM-20 | Specimen Availability | O | |||
| SPM-30 | Accession ID | O | Accession Number | ||
| SPM-32 | Shipment Tracking Number | O | Shipment Tracking Number |
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| TXA-1 | Set ID - TXA | R | 1 | ||
| TXA.2 | Document Type | CWE | R | Document Entry Type | 1054161000000101^Genetic report^SNM3 |
| TXA-4 | Activity Date/Time | TS | R | ||
| TXA.5 | Primary Activity Provider Code/Name | XCN | |||
| TXA.12 | Unique Document Number | EI | R | 1001166717^699X0 | |
| TXA-17 | Document Completion Status | R | F | ||
| TXA-24 | Folder Assignment | CWE | DocumentEntry Class | ||
| TXA-25 | Document Title | ST |
SPM|1|25GEN-029GN00001&R0A|^1001166717&699X0|258580003^Whole blood specimen^SNM3|||||||||||||20250129103726+0000|||Y
FHIR Resource Example: Specimen Example
This applies to HL7 v2 ORU_R01 feeds to the RIE.
ORC-3, ORC-12 (XCN) and ORC-21 (XON) SHALL be populated.
Coded Element. UK SNOMED CT is preferred and may be mandatory depending on use, for example for OXB Type ED, it will be required.
SNOMED
1054161000000101^Genetic report^SNM3
LOINC (from HL7 International)
53577-3^Reason for study^LN
51967-8^Genetic disease(s) assessed^LN
48018-6^Gene studied^LN
Extended Composite ID with Check Digit CX.1 - Id Number, CX-4 - Assigning authority and CX.5 - Identifier Type Code are mandatory
NHS Number
9449305552^^^NHS^NH
Medical Record Number
633^^^R0A^MR
Entity Identifier. EI.1 - Entity Identifier and EI.2 - Namespace Id are mandatory
Manchester University NHS Foundation Trust
1601737^R0A
North West GLH Hub
1001166717^699X0
This is based on the definition of PL from NHS England HL7 v2 ADT Message Specification SHOULD be followed and SHALL be used in ORC-12. In addition, this includes of PL.11 to hold organisation ODS code.
The ODS Site Code SHALL belong to the ODS Code. This is to help avoid data issues in this codesystem.
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| PL.4 | Facility | HD | R | Organisation Site Code | R0A09 |
| PL.11 | Assigning Authority For Location | HD | R | Organisation Code | R0A |
This is based on the definitions of NDL from Royal College of Radiologists
| Field HL7 | Fieldname | Data Type | Optionality | Identifier Type or ValueSet | Example Values |
|---|---|---|---|---|---|
| NDL-1.CNN.1 | Id Number | ST | O | Practitioner Identifier | |
| NDL-1.CNN.2 | Family Name | ST | O | Surname | |
| NDL-1.CNN.3 | Given Name | ST | O | Forename | |
| NDL-7 | Facility | HD | O | Organisation Code |
Extended Composite ID Number and Name for Persons. The definition of XCN from NHS England HL7 v2 ADT Message Specification SHOULD be followed and SHALL be used in ORC-12.
Example
GMC Code
C3456789^Darwin^Samuel^^^Dr^^^GMC
Extended Composite Name and Identification Number for Organizations. The definition of XON from NHS England HL7 v2 ADT Message Specification SHOULD be followed and SHALL be used in ORC-21.
Example
MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS
For the FHIR version see Bundle ‘Message’ - Genomics Order with Coded Entries
MSH|^~\&|HIVE|R0A|LIMS|699X0|20241013103300+0000||OML^O21^OML_O21|urn:uuid:9612365d-52a4-4fab-87e7-8a09d753f095|T|2.4|||AL
PID|1||633^^^R0A^MR~9449305552^^^NHS^NH||CHISLETT^Octavia||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
PV1|1|O|^^^R0A09^^^^^^^R0A||||C3456789^Darwin^Samuel^^^Dr^^^GMC|||100|||||||||1001166717|||||||||||||||||||||||||20250129103726+0000
ORC|NW|1601737^R0A|1001166717^699X0||||||20250129|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||^^R0A^^^ODS
OBR|1|1601737^R0A|1001166717^699X0|R240.1^^England-GenomicTestDirectory||20250129||||||||||C3456789^Darwin^Samuel^^^Dr^^^GMC
NTE|1||Referral lab PLEASE do following tests:
NTE|2||
NTE|3||Test(s) required: WGS
NTE|4||Sample type: Blood
NTE|5||Transport used: Merlin Courier
NTE|6||Tracking Number: ABC123
NTE|7||Sample sent to: LWH Genetics
NTE|8||By: PDAY on: 02/04/25
NTE|9||
NTE|10||Speciality Requesting Clinician: PAEDS
NTE|11||Test Group: Neurology
NTE|12||Ethnic Group: White British
NTE|13||Patient is from consanguineous union? : Unknown
NTE|14||Specimen Collection Status: Collect & send with order
NTE|15||Infection Risk: No Specific Risk
NTE|16||Clinical details:
NTE|17||
NTE|18||TESTING
NTE|19||Contact/Bleep No: 123
DG1|1||363349007^Malignant tumour of stomach^SNM3||20250129103726+0000
DG1|2||363349007^Malignant tumour of stomach^SNM3
OBX|1|CE|GENEAP^GENETICS TEST PERFORMABLE^NWGMSA|||||||||||20250129103726+0000
OBX|2|CE|230056^What Type of Referral Do You Require?^NWGMSA||1186936003^Storage of specimen (procedure)^SNM3|||||||||20250129103726+0000
OBX|3|CE|281269004^High infection risk sample^SNM3||LA32-8^No^LN|||||||||20250129103726+0000
OBX|4|ST|230016^Test Type^NWGMSA||Diagnostic Screen/Test|||||||||20250129103726+0000
OBX|5|CE|77386006^Pregnancy^SNM3||LA33-6^Yes^LN|||||||||20250129103726+0000
OBX|6|ST|231284^Please Select R240 Test(s):^NWGMSA||R240.1: Targeted variant testing|||||||||20250129103726+0000
OBX|7|ST|231285^Please Select R242 Test(s):^NWGMSA||R242.1: Targeted variant testing|||||||||20250129103726+0000
OBX|8|ST|230027^Email Addresses of Non-MFT Clinicians for Result Reports^NWGMSA||charu|||||||||20250129103726+0000
OBX|9|CE|762911000000102^Informed consent given for treatment^SNM3||LA33-6^Yes^LN|||||||||20250129103726+0000
OBX|10|ST|230037^Please Acknowledge That a DNA Sample Will be Stored in the Laboratory on Completion of Testing^NWGMSA||Acknowledged|||||||||20250129103726+0000
OBX|11|ST|230039^Is the Person Ordering the Test the Referring Clinician^NWGMSA||No|||||||||20250129103726+0000
OBX|12|ST|unknown^Name of Supervising Clinician^NWGMSA||DESHPANDE, CHARULATA|||||||||20250129103726+0000
OBX|13|ST|97209-1^Shipment tracking number^LN||UK3096580215|||||||||20250129103726+0000
OBX|14|CE|842009^Consanguinity^SNM3||LA32-8^No^LN|||||||||20250129103726+0000
OBX|15|DT|161714006^Estimated date of delivery^SNM3||20250512103726+0000|||||||||20250129103726+0000
SPM|1|25GEN-029GN00001&R0A|^1001166717&699X0|258580003^Whole blood specimen^SNM3|||||||||||||20250129103726+0000|||Y
For the FHIR version see Bundle-NonWGSTestOrderForm-CancerSolidTumor-Example
MSH|^~\&|HIVE|RAX|LIMS|RJZ|20241013103300+0000||OML^O21^OML_O21|156bb6ab-15e7-42f3-a819-ecd16a5b4fbd|T|2.4|||AL
PID|1||9449307555^^^NHS^NH||Hadjkiss^Zelma||20110319||||2 Barclay Close^Fetcham^^^KT22 9SY
ORC|NW||||||||20230908|||9999999998^Smith^Hazel^^^Dr.^^^SDS|||||||||Kingston Hospital NHS Foundation Trust^^RAX01^^^ODS
OBR|1|||M119.5^Multi Target NGS Panel Small^England-GenomicTestDirectory||20230908||||||||||9999999998^Smith^Hazel^^^Dr.^^^SDS
NTE|1||Free text for diagnosis/reason for referral, transplant, life status at time of request details/ e.g. malignant tumour - molecular assessment will aid management
DG1|1||363358000^Malignant tumour of lung^SNM3
DG1|2||relapse^Relapse^England-ReasonForTesting
OBX|1|CE|128462008^Metastatic malignant neoplasm (disorder)^SNM3|||||||||||20230908
OBX|2|CE|6574001^Necrosis (morphologic abnormality)^SNM3|||||||||||20230908
SPM|1|RA257630||364611000000101^Tissue resection sample^SNM3|||||||||||||20230909110000Z|||Y
MSH|^~\&|iGene|699X0|EPIC|R0A|20190514102527+0200||ORU^R01^ORU_R01|5051095-201905141025|T|2.5.1|||AL
PID|1||633^^^R0A^MR~9449305552^^^NHS^NH||CHISLETT^Octavia^^Miss||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
PV1|1|N|^^^R0A09^^^^^^^R0A|||||C3456789^Darwin^Samuel^^^Dr^^^GMC||311|||||||||12345^^^R0A
ORC|RE|1601737^R0A|1001166717^699X0||CM||||20170126143602|||C3456789^Darwin^Samuel^^^Dr^^^GMC|||||||||MANCHESTER UNIVERSITY NHS FOUNDATION TRUST^^R0A^^^ODS
OBR|1|1601737^R0A|1001166717^699X0|R240.1^Diagnostic testing for known variant(s)^England-GenomicTestDirectory|||20190514102000+0200|||SCC|O|||20190514102000+0200||C3456789^Darwin^Samuel^^^Dr^^^GMC||||||20190514102417+0200
OBX|1|ED|1054161000000101^Genetic report^SNM||MOL^IM^PDF^Base64^JVBERi0x...||||||F
MSH|^~\&|IGENE|699X0|GMCR|QOP|20250814094223+0000||MDM^T02|ORIE-250814-0|T|2.4|||AL
EVN|T02|20250814094223+0000
PID|1||633^^^R0A^MR~9449305552^^^NHS^NH||CHISLETT^Octavia^^Miss||20080920|F|||1 RAVENSFIELD GARDENS^^EPSOM^SURREY^KT19 0ST
PV1|1|N|^^^R0A09^^^^^^^R0A|||||C3456789^Darwin^Samuel^^^Dr^^^GMC||311|||||||||12345^^^R0A
TXA||1054161000000101^Genetic report^SNM||||20250814094116+0000||||||T25-01FU
OBX|1|ED|1054161000000101^Genetic report^SNM||^AP^PDF^Base64^JVBERi0xLjQKJeL...