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use strict;
use warnings;
...
my %data = %{XMLin ($str)};

Dump (\%data);

__DATA__
<PATIENT_DATA>
...
<Race>Caucasian</Race>
</SA_PATIENT>
</PATIENT_DATA>

$HASH1 = { SA_PATIENT => [
           {
...
             Zip      => 10110
           }
         ] };