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Get Ps 05 Form Pdf

Worker s telephone number: PROPERTY SUPPLEMENT STOP: If you are applying for no-cost Medi-Cal only for children under age 19 and/or pregnant women applying only for pregnancy-related services, you do not need to complete this form. You may be contacted later if necessary. GO: If you are applying for full-coverage Medi-Cal for a family including adults, please complete this form and be sure to list all your property. The county.

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