census 2

 

 

MMS grey dots logo revised

Confidential Employee Census
 
#
 
EMPLOYEE NAME
 
SEX
 
AGE
 
STATUS
 
SALARY
 
TITLE
 
16
 
17
 
18
 
19
 
20
 
21
 
22
 
23
 
24
 
25
 
26
 
27
 
28
 
29
 
30
 
31
 
32
 
33
 
35
 
36
 
37
 
38
 
39
 
40
 
41
 
42
 
43
 
44
 
45
 
46
 
47
 
48
 
49
 
50
 
51
 
52
 
53
 
54
 
55

 

Please complete and fax this form to Medical Solutions  at: (212) 302-0222 or

E-Mail info@medicalsolutionscorp.com
For Questions, please call us at (914) 207-6161 or toll-free at (855) 677-4621