if A.PTID exists, it must equal B.PTID, but if A.PTID is NULL, that is fine. (I suspect this SHOULD be on the B side)
Let me rewrite this a little
WHERE A.PTID=B.PTID (+) AND A.PTID = C.PTID (+) AND A.PTID =D.PTID (+) and A.PAT_EXT_ID = '69910.0';
Say A.PAT_EXT_ID has to equal 69910.0
and if B.PTID exists, it must equal A.PTID, but if not make every B column a NULL
and if C.PTID exists, it must equal A.PTID, but if not make every C column a NULL
and if D.PTID exists, it must equal A.PTID, but if not make every D column a NULL
this will allow you to see every row in A that matches 69910.0, even if no row like that is in B, C, or D; but if they do match, they are shown too.
I tried to remain child-like, all I acheived was childish.
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