18 Piedmont Street Complaint 3-13-2019 CITY OF SALEM, MASSACHUSETT'S
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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 LRAMDIN _SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: .2 Received By: jwy
Complaint Number: 2376
Complainant
Address: tlis l f Phone:
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Investigated By: ._ _ Date:
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