393 Essex Street Complaint 8-1-2019 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(a]SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: _ Time: _ Received By:
Complaint Number: 2519 ?/
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