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Efta Id
-
Dataset
-
Hash Sha256
6de7ac0a102babecacab70c1a14fdd8d4e509225699a14f14c457949b1c4aaca
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OCR text
Page 1 LSJE, LLC 6100 Red Hook Quarters. Suite B-3. St. Thomas. VI 00802-1348 E-mail: thesaintjames.group@gmail.com Phone: Emergency Contact Form Start Date: 10/15/18 Today's Date: Employee Name: }Carlos L Rodriguez Thomas. VI 06802 Physical Address' Mailing Address. Date of Birth: ro. Red Hook a Cell Phone: Phone (other): E-mail: U Marital Status: Title/Position: Faotain Driver's License No: I.= Allergies or Health Concerns: lamed L Blood type: El A- D A+ D AB- C AB+ El g- EJ 8+ o- D o+ QX Unknown Current Medications: r ime Doctors Name: Livingston Doctors Phone: Doctors Name: Doctor's Phone: In case of emergency, please contact: Name: Relationship: Phone: Name: Relationship: Phone: This information is for your safety and the safety of others. EFTA00003045 é ’ “« i) LSJE, LLC i 6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348 = —~ Phone: {EJ E-mail: thesaintjames.group@gmail.com C9 Emergency Contact Form : i i Employee Name: Carlos L Rodriguez / Date of Birth: | RR i Physical Address: ’ eae 15501 Red Hook Plaza a Mailing Address te) | | Title/Pasition j\Carta } Driver's License No: EE _ 4 pe Allergies or Health Concerns age ' Blood type CA [As 7] AB Oa OB CD B+ Oo 0 oO [X] Unknown Current Medications ‘celiac if Doctor's Name: [Dr. Livingston ~*'Y Doctor's Phone: _ sninin = { - _— $$$ i - H n case of emergency, please contact: : Name | ti(‘(<ié‘z@Q Relationship: Wife : | is = iain a) This information is for your safety and the safety of others. ° s ; : 4 : e x : : — ‘ _ EFTA00003045
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EFTA00003045.pdf
Content type
application/pdf
Source path
/srv/provenance-intake/investigations/dcba1340-07e3-447a-a007-c6748522c796/processing/VOL00001/IMAGES/0004/EFTA00003045.pdf
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6de7ac0a102babecacab70c1a14fdd8d4e509225699a14f14c457949b1c4aaca
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admin
Created
07/15/2026 - 11:46
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Document status: uploaded
Stored OCR text: 1,598 characters
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