📄 Extracted Text (98 words)
LSJE, LLC
6100 Red Hook uarters, Suite B-3. St. Thomas, VI 00802-1348
E-mail:
Emergency Contact Form
Today's Date: 10/15/18 Start Date:
Employee Name: Carlos L Rodriguez Date of Binhl
Physical Address:
Mailing Address!
Cell Phone: Phone (other):
1
E -mad: Marital Status: Married
Title/Position:
Faptain
C— Driver's License No:
-4
Allergies or Health Concerns:
Blood type:
Current Medications: INone
L
Doctor's Name: Dr. Livingston Doctor's Phone:
Doctor's Name: Doctor's Phone:
In case of emergency, please contact:
Name: Rebecca Rodriguez Relationship: Wife Phone: 1
Name: Relationship: Phone:
This information is for your safety and the safety of
others.
EFTA01342046
ℹ️ Document Details
SHA-256
d571e0d338d6a3d66fadc2feff43cc1d901ffca010c3a7d1995ecd7b15fade48
Bates Number
EFTA01342046
Dataset
DataSet-10
Document Type
document
Pages
1
Comments 0