36 PERKINS STREET - TRASH COMPLAINT X CITY OF SALEM, MASSACHUSETTS
BOARD OF Ih-,ALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4r"FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS!REHS,CHO,CP-FS 1,RAMDIN(ii'SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: 7 Time: Received By:mfow 11
Complaint Number: 1741
Complainant
Address- Phone:
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