296 Washington Street Complaint 6-10-2019 a
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"H FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDINLa SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: h Ar Time: Received By:
Complaint Number: 2456
Complainant
Address: ;, Phone:
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