INTEGRATION_CONTROL_NUMBER^1012638925V204624
SURNAME^NWHINZZZTESTPATIENT
FIRST_NAME^NWHINTWO
MIDDLE_NAME^
NAME_PREFIX^
NAME_SUFFIX^
MOTHERS_MAIDEN_NAME^NWHINZZZTESTPATIENTJONES
DATE_OF_BIRTH^Jan_02,_1982
PLACE_OF_BIRTH_CITY^PITTSBURGH
PLACE_OF_BIRTH_STATE^PENNSYLVANIA^PA
DATE_OF_DEATH^
GENDER^MALE^M
SOCIAL_SECURITY_NUMBER^666100002
SSN_VERIFICATION_STATUS^^
PSEUDO_SSN_REASON^^
PRIMARY_ICN^
DATE/TIME_OF_ORIGINAL_CREATION^JUN_06,_2011@12:19:41
FACILITY_OF_ORIGINAL_CREATION^DAYTSHR^984
CREATED_BY^PATEL,TUSHAR
RESOLUTION_JOURNAL_CASE_NUMBER^^
PRIMARY_VIEW_DATE_LAST_UPDATED^JUL_17,_2014@08:51:32
IDENTITY_THEFT^^
TEMPORARY_ID_NUMBER^
FOREIGN_ID_NUMBER^
SELF_IDENTIFIED_GENDER^^
STREET_ADDRESS_[LINE_1]^
STREET_ADDRESS_[LINE_2]^
STREET_ADDRESS_[LINE_3]^
CITY_[RESIDENCE]^
STATE_[RESIDENCE]^^
ZIP+4_[RESIDENCE]^
PHONE_NUMBER_[RESIDENCE]^
MULTIPLE_BIRTH_INDICATOR^^
PROVINCE^
POSTAL_CODE^
COUNTRY^^
ID_STATE^PERMANENT^P
DATE_OF_ID_STATE^JUN_06,_2011@12:19:41
ALIAS^1^~~~~~
RACE_INFORMATION^1^^~
ETHNICITY_INFORMATION^1^^~