Accident Detail Receipt
Date And Time 04-Oct-2017 / 4:00 am
Place of Accident Bablaj Holnanthe Road (Rastyavar) Daryasing Rajput chya Sheta Near
CR NO/ TAR No/ SDE NO 50/2017 IPC 304(A),279,337,338
Name of the Injured/ Deceased Deceased Name Aamlal Junzrya Bhil (pawara) Injured Name Sumanbai Aamlal Bhil (Pawara)
Name of The Hospital to which he/she was removed Cottege Hospital Shirpur
Number of vehicle and type of the vehicle Motar Cycle MH 19 BB 9379
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. Habbib Razzak Khatik At.Post Bhorkheda Tal Shirpur Dist Dhule Licence No MH18
Name of the owner of the vehicle as it stand on the date of the accident Yeshunath Harchand Bhil At.Post Bhorkheda Tal Shirpur Dist Dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. IFFICO TOKIO GEN.INSU.CO.LTDCTS NO.3041/2 RAJYOG TOWER NEAR SHER -E-PANJAB HOTEL PAANCH KANDIL CHOWK
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate INSURANCE POLICY NUM.1EBLQ52G,INSURANCE VALIDETY 12/04/2018
Action Taken if any, and the result thereof. INVESTIGATION

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