4 SZETELA LANE - STREET FILE 4 �-��� L
"$ 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 LRAMDINw SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Dater Time: Received By: lbi tV
Complaint Number: 1680
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