when did patient 65124 first come into the hospital via the transfer from hosp/extram until 4 years ago?
select admissions.admittime from admissions where admissions.subject_id = 65124 and admissions.admission_location = 'transfer from hosp/extram' and datetime(admissions.admittime) <= datetime(current_time,'-4 year') order by admissions.admittime asc limit 1