65 MASON STREET - RODENT COMPLAINT :.
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"'FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINrSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: 2A 11q Time: "} Received By: _
Complaint Number: 2192
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Complainant
Address: �s� I j /rC'� Phone: 17
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