Enter the patient's FMP code in the two diamonds preceding the SSN using Table 1-1.
DATA ON FRONT COVER OF THE DENTAL RECORD JACKET
All entries on the front cover, except "Pencil Entries" are made with black felt-tip pen.
Use the following instructions to complete the next sections.
Enter the patient's name in the upper-right corner in the following sequence: last, first, middle.
Indicate no middle name by the abbreviation "NMN." The name should be written on the line provided.
For all retired flag and general officers (i.e., 0-7 and above), enter the phrase "FLAG OFFICER" or "GENERAL OFFICER," as appropriate, in the lower portion of the patient's identification box.
Immediately below the instruction box, indicate in the alert box whether the patient has sensitivities or allergies by entering an "X" in the appropriate boxes (if none, leave blank).
Enter the patient's command and grade or rate for active duty. For all others enter their preferred form of address.
Table 1-1. - Family Member Prefix Codes
Relationship to Sponsor | FMP Code |
Sponsor's oldest child (including stepchildren) | 01 |
Sponsor's next oldest child | 02 |
Sponsor's third oldest child, etc. | 03 |
Sponsor (active duty, retired, and Reserve uniformed services personnel of Army, Air Force, Marine Corps, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration) | 20 |
* Sponsor's current spouse | 30 |
* Sponsor's eligible former spouses | 31-39 |
Sponsor's family member mother/stepmother | 40-44 |
Sponsor's family member mother-in-law | 50-54 |
Sponsor's family member father-in-law | 55-59 |
Other authorized sponsor's family members | 60-69 |
Beneficiaries authorized by statute (SECNAV designees, etc.) | 90 |
Non-beneficiary emergencies | 98 |
All other authorized personnel (foreign national, etc.) | 99 |
* The spouse of a deceased sponsor will continue to use the sponsor's SSN. If the sponsor had no SSN, use the sponsor’s military serial or service number preceded by leading zeros to complete a 9-digit number.
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