Cleveland and Munroe Complaints 5-13-2019 ml CITY OF SALEM, MASSACHUSETTS
w' 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( ,•SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: ,'Q Received By:
Complaint Number: 2434
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