<PreEncounter>
	<SenderData ProviderName="My Org" ProviderETIN="94203283999" BatchNumber="20060504-003"/>
	<DocumentFunction DocumentNumber="20060504-003-001" DocumentFunction="2" DMHID="700106">
		<EpisodeCare Division="ADA" EnrollingProviderSiteName="Columbia" EnrollingProviderSiteID="406" AdmissionDateTime="2006-04-05 12:00" AdmissionReason="2" ReferralSource="400" ReferralOffice="27" LocalChartNumber="3456A" FamilySize="1" NumberOfChildrenInCare="0">
			<Diagnosis Axis="1" DiagnosisDateTime="2006-04-05 16:00" DiagnosticianName="Helen Days" DiagnosisCodeSet="ICD-9" DiagnosisCode="300.1" Status="Admission" Severity="Catastrophic" Principal="1" Primary="1"/>
			<Commitments CommitmentType="400" CommitmentFromDate="2006-04-05" CommitmentCounty="099" PrimaryIndicator="1"/>
		</EpisodeCare>
	</DocumentFunction>
</PreEncounter>
