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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 Tina Simmons<br />

<br />

<br />

<br />

<br />

<br />

Tina Simmons:<br />

is Margaret Simmons’ child<br />

was born 05/15/2000, based on Margaret’s statement<br />

is a black female<br />

her Social Security number is 595 02 XXXX, based on Margaret’s statement<br />

REGISTER HOUSEHOLD MEMBER - MEMB MEMB 02<br />

01<br />

Client ID<br />

Del<br />

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

Relationship CH DOB (MM DD YYYY) 05 15 2000 V CS Sex F<br />

SSA/SSN Appl For SSN1 595 02 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-19

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