📄 Extracted Text (90 words)
LSJE, LLC
00802 Tel: Fax:
6100 Red Hook Quarters Suite B-3 St. Thomas, VI
sir
Tor _
3
Emergency Contact Form
Start Date:
Date: 04/11/12
Employee Name: Randy Amparo
Address: Date of Birth:
Phone: Cell: E-Mail:
Title / Position: Boat Captain Marital Status: License:
mergency Information:
NA
Allergies or Health Concerns:
Blood Type: IO
Current Medication:
Doctor's Name: Phone:
Doctor's Name: Phone:
In case of an Emergency, Please contact :
Name Relationship Father Phone
Jame Relationship Mother Phone
This Information is for your safety and the safety of
others
EFTA01342068
ℹ️ Document Details
SHA-256
15c0490c0d6f8d0dec644ce31ca38f5facf3abd03cb11e48e8c8ac8bfe05c78a
Bates Number
EFTA01342068
Dataset
DataSet-10
Document Type
document
Pages
1
Comments 0