40R Highland Ave #509 Complaint 8-15-2019 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 LRAMDIN(1!SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: 1�, ��,� Received By:
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Complaint Number:
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Investigated By: _ Date: _
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