5 Chase Street #1 Complaint 5-15-2018 a
CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4T"FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINQR SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date:, � Time: z _ Received By:
Complaint Number: 2115
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