DANIELS 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 LRAMDIN6vSALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: '� ':`;� Time: /' ..'' Received By:
Complaint Number: 2193 _
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