EPSTEIN
page 6 / 717 . OCR, unverified
Emergency Contact Form
Employee Name: Cristobal Hidalgo Herrera
Address:
Boyoni 25C
Phone:
Position: hTigatio•
Celt:
Start Date:
Date of Birth
E-Mail:
Marital Status
License: r
i'mergency information:
Blood type unspecified
Allergies or Health Concerns:
Blood Type:
Current Medication:
Doctor's Name:
Doctor's Name:
None
Phone:
Phone:
In case of an Emergency, Please contact :
Name
g.-
flame
Villglo Herrera
Relationship
Brother
Phone
Relationship
Phone
This Information is for your safety and the safety of others
EFTA01342047
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EFTA01342048
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LSIE, LLC
Emergency Contact Form
Start Date:
Date:
04/10/18
Employee Name: Dalce Gusneme
Address:
Date of Birth: 12/28/66
Phone:
340-643-4374
E-Mail:
/ Position:
Marital Status: Married
License:
mergency Informatir
Allergies or Health Concerns:
Blood Type:
Blood type no specified
Current Medication:
Doctor's Name:
Phone:
Doctor's Name:
Phone:
In case of an Emergency, Please contact :
Name
Licimene Dalce
Relationship
Sister
JI. a me
Relationship
Phone
This Information is for your safety and the safety of others
• .••
V.
Phone
340-344-1819
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LSJE, LL
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 0080
Date:
06/04/18
Employee Name: Danny Etienne
Addeess:
Pi-1r
Title / Position: Maiwer ..--
00111110
Emergency In€ormation:
Allergies or Health Concerns:
Blood Type:
Current Medication:
Doctor's Name:
Doctor's Name:
Emergency Contact Form
Start Date:
Cet
Date of Birth: 04/04/78
E-Mail:
Marital Status: Single
License:
Phone:
Phone:
In case of an Emergency, Please contact :
Name
Maria
ame
Shahan' Grant
Relationship
Etienne
Phone
Relationship
Girlfriend
Phone
This Information is for your safety and the safety of others
AMC
IML
EFTA01342050
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LSJE, LLC
6100 Red Hook Quarters. Suite B-3 St. Thomas. VI 00802-1348
Phone:
E-mail:
Today's Date:
110/18/18
Employee Name: [D__nald Poilon
Physical Address: I
Emergency Contact Form
Start Date:
Date of Birth:
E-mail:
Marital Status:
Title/Position:
Driver's License No:
Blood type:
E A-
El A+
K AB-
AB+
Current Medications:
Doctor's Name:
Doctor's Name:
In case of emergency, please contact:
Name: Jemine Reed
Name: Brian Bates
Relationship:
Relationship:
Doctor's Phone:
Doctor's Phone:
Phone:
Phone:
This information is for your safety and the safety of others.
Unknown
EFTA01342051
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LSJE, LLC
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel:
Emergency Contact Form
Date:
04/10/18
Employee Name: l?ullson B. Donissaint
Start Date:
04/10/18
Address:
6043 Frydenhoj, St Thomas. VI 00802
Date of Birth
Phone.
E-Mail:
/
Marital Status:
License:
mergency
Allergies or Health Con.,:e;-r.l,..
Blood Type:
Current Medication:
Doctor's Name:
Doctor's Name:
In case of an Emergency, Please contact :
Name
Angel Lundy
Relationship
me
Relationship
Phone:
Phone:
This Information is for your safety and the safety of others
EFTA01342052
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LSJE, LLC
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108
Date:
06/14/18
Emergency Contact Form
Start Date:
Employee Name: Felito Joseph
Address:
State Nadir #6A
Date of Birth:
?none
E-Mail:
/ Position: Tr.
Marital Status: Single
License:
Emergency
Allergies or Health Concerns:
Blood Type:
IlF±I
Current Medication:
Doctor's Name:
Doctor's Name:
In case of an Emergency, Please contact :
Phone:
Phone:
Girlfriend
Phone
sister
Phone
This Information is for your safety and the safety of others
EFTA01342053
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r
6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802 Tel: 340-775-8100 Fax: 340-775-8108
•
LSJE, LLC
Emergency Contact Form
Date:
03/19/18
Start Date:
Employee Name: Gael J Leatham
Address:
Date of Birth
Phone:
Cell:
E-Mail:
Title / Position: Lamiscapirig
Marital Status: Single
License:
e"N
t
ergency Information: