277 Lafayette Street #1 Complaint 10-4-2018 CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINO�SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: I; Received By:L/I q
Complaint Number: 2275
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Investigated By: Date:
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