Accident Detail Receipt
Date And Time 01-Sep-2017 / 9:00 am
Place of Accident NEAR SANGVI GAON , ON MUMBAI TO AGRA HAIGWAY ROAD, OPP MOTIRAM MANOO PAWRA FRAM
CR NO/ TAR No/ SDE NO 74/2017 IPC 279,337,338,427,R/W MV ACT 184
Name of the Injured/ Deceased SURESH KAUTIK LODHE AGE 60 ADD- SANGVI TAL SHIRPUR DIST DHULE
Name of The Hospital to which he/she was removed 1) COTTAGE HOSPITAL SHIRPUR 2) HIRE MEDICAL COLLEGE DHULE
Number of vehicle and type of the vehicle RJ 27 GC 1396 MALTRUCK VEHICLE
Name of address of driver of the vehicle with perticuler ordriving license of the said driver and the address of the issuing Authority of the said driver license. The number of badge in case of public service vehicle and the address of the issuing Authority of the said badge. ANIL BABULAL MALI AGE- 27 ADD- MANDAL GARH DIST BHILWARA RAJ. LICENCE NO- RJ0620090089480 ISSUINNG AUTHORITY- BHILWARA
Name of the owner of the vehicle as it stand on the date of the accident JITENDRA KUMAR ADD- 26 W NO 14 CHANDRA COLONY PRATAP NAGAR UDAIPUR
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. TATA AIG GENERAL INSURANCE COMPANY LTD.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 015668522200 VALID DATE 03/02/2018
Action Taken if any, and the result thereof. SUBMITED CHARGESHEET TO COURT RESULT- COURT PEANDING
FIR COPY Download Document 1
PANCHNAMA COPY Download Document 2
MEDICAL CERT. Download Document 3

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