|^~\&SENDING_APPLICATIONSENDING_FACILITYRECEIVING_APPLICATIONRECEIVING_FACILITY202303211200ADTA02123456789P2.8A022023032112001123456789HOSPMRDoeJaneEMs.19850515FCaucasian456 Oak St.AnytownST98765USA(555)555-6789(555)555-4321M987654321987-65-43211DoeJohnEMr.456 Oak St.AnytownST98765USA(555)555-0123(555)555-4567Emergency Contact1I2000ICU01BuildingA3123456SmithJohnDr.ICU123NurseNancyRN2023032012002023032112001234General MedicalCondition9876543210I9876543212023032112001I2000ICU01Urgent2023032011591234Severe respiratory distress2023032012002023032112001PenicillinSevere2AspirinModerate1ICD10J45.909Unspecified asthma, uncomplicated202303201200A120230320120002Appendectomy202303201200123456PlannedSuccessful123456781AD123456SmithJohnDr.Primary Care Physician