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Customer Contact Center Food Stamp/Family Medicaid Phase II ...

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Call <strong>Center</strong> FS/FM SUCCESS PG October 24, 2007<br />

Screening and Registration<br />

MEMB for Margaret Simmons<br />

Margaret:<br />

<br />

<br />

<br />

was born December 5, 1980 based on her statement<br />

is a black female<br />

has a Social Security number of 595 01 XXXX (customize the SSN), based<br />

on her statement<br />

<br />

is pregnant; however, do not code pregnancy field<br />

REGISTER HOUSEHOLD MEMBER - MEMB MEMB 01<br />

01<br />

Client ID<br />

Del<br />

F Name MARGARET MI L Name SIMMONS Suf<br />

Relationship SE DOB (MM DD YYYY) 12 05 1980 V CS Sex F<br />

SSA/SSN Appl For SSN1 595 01 XXXX V CS Race: B W A N P Ethnic: N<br />

Preg Due Date Y N N N N<br />

Alternate Names F Name MI L Name Suf<br />

More Names<br />

Additional SSNs<br />

SSN V SSN V SSN V SSN V<br />

More SSNs<br />

Message 0013<br />

0013 REQUIRED FIELDS ARE IDENTIFIED BY "?"<br />

18-tbud<br />

More Members<br />

24-del<br />

PG-16

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