anchor.diff:    </div>
   
     <div class="form-group">
  -      <fieldset id="dob">
  -        <legend id="dob-label">Date of birth</legend>
  -        <label for="dob_month">Month
  -          <input id="dob_month" name="dob_month" type="month" required />
  -        </label>
  -        <label for="dob_day">Day
  -          <input id="dob_day" name="dob_day" type="day" required />
  -        </label>
  -        <label for="dob_year">Year
  -          <input id="dob_year" name="dob_year" type="year" required />
  -        </label>
  -      </fieldset>
  -  </div>
  -
  -  <div class="form-group">
  -      <label for="ssn">Social Security Number</label>
  -      <input for="ssn" name="ssn" type="text" placeholder="000-33-0000" />
  -      <span class="help-block">You may be able to receive Medi-Cal even if you do not have a Social Security Number.</span>
  +    <fieldset id="dob">
  +      <legend id="dob-label">Date of birth</legend>
  +      <label for="dob_month">Month
  +        <input id="dob_month" name="dob_month" type="month" required />
  +      </label>
  +      <label for="dob_day">Day
  +        <input id="dob_day" name="dob_day" type="day" required />
  +      </label>
  +      <label for="dob_year">Year
  +        <input id="dob_year" name="dob_year" type="year" required />
  +      </label>
  +    </fieldset>
     </div>
   
     <div class="form-group">
  
positive.code: 
    <!-- Phone numbers -->
    <!-- "Message number" instead of home/work number -->
    <div class="form-group">
      <label for="message_phone_number_area_code">Area code</label>
        <input type="text" class="form-control" name="message_phone_number_area_code" placeholder="415">
      <label for="message_phone_number">Phone number</label>
        <input type="text" class="form-control" name="message_phone_number" placeholder="555-5555">
        <span class="help-block">A phone number where it's okay to leave a message.</span>
    </div>
  
    <div class="form-group">
  
negative.code:   </div>
  
    <div class="form-group">
        <label for="ssn">Social Security Number</label>
        <input for="ssn" name="ssn" type="text" placeholder="000-33-0000" />
        <span class="help-block">You may be able to receive Medi-Cal even if you do not have a Social Security Number.</span>
    </div>
  
    <div class="form-group">
      <fieldset id="citizen-field">
        <legend id="citizen-label">Are you a U.S. citizen or national?</legend>
        <label for="citizen_yes" class="radio-inline">
         <input type="radio" name="citizen" id="citizen_yes" value="Yes" required />
         Yes
        </label>
        <label for="citizen_no" class="radio-inline">
          <input type="radio" name="citizen" id="citizen_no" value="No" required />
          No
        </label>
      </fieldset>
      <fieldset id="us-entry-dates">
        <legend id="us-entry-dates-label">If "No," on what date did you enter the U.S.?</legend>
        <label for="us_entry_month">
          Month
          <input id="us_entry_month" name="us_entry_month" type="month" required />
        </label>
        <label for="us_entry_day">
          Day
          <input id="us_entry_day" name="us_entry_day" type="day" required />
        </label>
        <label for="us_entry_year">
          Year
          <input id="us_entry_year" name="us_entry_year" type="year" required />
        </label>
      </fieldset>
    </div>
  
  