📄 Extracted Text (90 words)
LSJE, LLC
, VI 00802 Tel: 340-775 -8100 Fax: 340-775-8108
Quarter s Suite B-3 St. Thomas
6100 Red Hook
Emergency Contact Form
Start Date: 05/04/17
Date: 04/10/18
Employee Name: James Cesar
Date of Birth:
Address:
Cell: E-Mail:
Phone:
Title / Position: Carpenter Marital Status: Married License: I
ilits—Amergency Info' ] n:
Allergies or Hee
Blood Type:
Current Medication:
Doctor's Name: Phone:
Doctor's Name: Phone:
In case of an Emergency, Please contact :
Name Wisner Piern Relationship Phone
Phone
This Information is for your safety and the safety of others
EFTA01304180
ℹ️ Document Details
SHA-256
1e8bf7af347ab1df1268567da1dd4b1e81300fd7a1523120a93f21932fce3ac2
Bates Number
EFTA01304180
Dataset
DataSet-10
Document Type
document
Pages
1
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