<?xml version="1.0" encoding="UTF-8"?>
<PreEncounter>
	<SenderData ProviderName="My Org" ProviderETIN="94203283999" BatchNumber="20060504-008"/>
	<DocumentFunction DocumentNumber="20060504-008-001" DocumentFunction="8" DMHID="700106">
		<EpisodeCare Division="ADA" EnrollingProviderSiteName="Eldon" EnrollingProviderSiteID="408" AdmissionDateTime="2006-03-23 12:00">
			<Diagnosis Axis="1" DiagnosisDateTime="2006-03-25 12:00" DiagnosticianName="John Matrix" DiagnosisCodeSet="ICD-9" DiagnosisCode="301.0" Status="Current" Severity="Mild"/>
		</EpisodeCare>
	</DocumentFunction>
</PreEncounter>
