iNTERFACEWARE™ Inc.

<?xml version="1.0"?>
<PatientRegister>
  <MSH.MessageHeader>
     <MSH.1.FieldSeparator>|</MSH.1.FieldSeparator>
     <MSH.2.EncodingCharacters>^~\&amp;</MSH.2.EncodingCharacters>
     <MSH.4.SendingFacility>
        <HD.HierarchicDesignator>
           <HD.1.NamespaceID>.</HD.1.NamespaceID>
        </HD.HierarchicDesignator>
     </MSH.4.SendingFacility>
     <MSH.7.DateTimeOfMessage>
        <TS.TimeStamp>
           <TS.1.TimeOfAnEvent>19990818001600+0000</TS.1.TimeOfAnEvent>
        </TS.TimeStamp>
     </MSH.7.DateTimeOfMessage>
     <MSH.9.MessageType>
        <MSG.MessageType>
           <MSG.1.MessageType>ADT</MSG.1.MessageType>
           <MSG.2.TriggerEvent>A04</MSG.2.TriggerEvent>
        </MSG.MessageType>
     </MSH.9.MessageType>
     <MSH.10.MessageControlID>ADT.1.1698593</MSH.10.MessageControlID>
     <MSH.11.ProcessingID>
        <PT.ProcessingType>
           <PT.1.ProcessingID>P</PT.1.ProcessingID>
        </PT.ProcessingType>
     </MSH.11.ProcessingID>
     <MSH.12.VersionID>
        <VID.VersionIdentifier>
           <VID.1.VersionID>2.1</VID.1.VersionID>
        </VID.VersionIdentifier>
     </MSH.12.VersionID>
  </MSH.MessageHeader>
  <PID.Patientidentification>
     <PID.1.SetIDPID>1</PID.1.SetIDPID>
     <PID.3.PatientIdentifierList>
        <CX.ExtendedCompositeIDWithCheckDigit>
           <CX.1.ID>000395122</CX.1.ID>
        </CX.ExtendedCompositeIDWithCheckDigit>
     </PID.3.PatientIdentifierList>
     <PID.5.PatientName>
        <XPN.ExtendedPersonName>
           <XPN.1.FamilyName>
              <FN.FamiliyName>
                 <FN.1.Surname>LEVERKUHN</FN.1.Surname>
              </FN.FamiliyName>
           </XPN.1.FamilyName>
           <XPN.2.GivenName>ADRIAN</XPN.2.GivenName>
           <XPN.3.SecondAndFurtherGivenNamesOrInitialsThereof>C</XPN.3.SecondAndFurtherGivenNamesOrInitialsThereof>
        </XPN.ExtendedPersonName>
     </PID.5.PatientName>
     <PID.7.DateTimeOfBirth>
        <TS.TimeStamp>
           <TS.1.TimeOfAnEvent>19880517180606+0000</TS.1.TimeOfAnEvent>
        </TS.TimeStamp>
     </PID.7.DateTimeOfBirth>
     <PID.8.AdministrativeSex>M</PID.8.AdministrativeSex>
     <PID.11.PatientAddress>
        <XAD.ExtendedAddress>
           <XAD.1.StreetAddressSAD>
              <SAD.StreetAddress>
                 <SAD.1.StreetOrMailingAddress>6 66TH AVE NE</SAD.1.StreetOrMailingAddress>
              </SAD.StreetAddress>
           </XAD.1.StreetAddressSAD>
           <XAD.3.City>WEIMAR</XAD.3.City>
           <XAD.4.StateOrProvince>DL</XAD.4.StateOrProvince>
           <XAD.5.ZipOrPostalCode>98052</XAD.5.ZipOrPostalCode>
        </XAD.ExtendedAddress>
     </PID.11.PatientAddress>
     <PID.13.PhoneNumberHome>
        <XTN.ExtendedTelecommunicationNumber>
           <XTN.1.9999999999x99999cAnyText>(157)983-3296</XTN.1.9999999999x99999cAnyText>
        </XTN.ExtendedTelecommunicationNumber>
     </PID.13.PhoneNumberHome>
     <PID.16.MaritalStatus>
        <CE.CodedElement>
           <CE.1.IdentifierST>S</CE.1.IdentifierST>
        </CE.CodedElement>
     </PID.16.MaritalStatus>
     <PID.18.PatientAccountNumber>
        <CX.ExtendedCompositeIDWithCheckDigit>
           <CX.1.ID>12354768</CX.1.ID>
        </CX.ExtendedCompositeIDWithCheckDigit>
     </PID.18.PatientAccountNumber>
  </PID.Patientidentification>
</PatientRegister>