12 Dundee Street Complaint 5-14-2019 CITY OF SALEM, MASSACHUSETTS
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BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4TH FLOOR
f MAYOR TEL.(978)741-1800
1 FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDIN(�v SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: Received By: zm ,nelaai 6
Complaint Number: 2438 _
Complainant
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