Accident Detail Receipt
Date And Time 11-Jul-2017 / 8:30 pm
Place of Accident NEAR SHERHIND HOTEL NATIONAL HIGH WAY NO 06 ASTANE VILLAGE
CR NO/ TAR No/ SDE NO CR NO 79/2017 IPC 279,337,338,427 MVA 184,134/177
Name of the Injured/ Deceased JAGNNATH YASHAWANT DEVARE 68 YRES OLD AT POST -ASTANE TAL-SAKRI DIST-DHULE
Name of The Hospital to which he/she was removed 1) RURAL HOSPITAL SAKRI 2) DEVARE ACCIDENT HOSPITAL DHULE
Number of vehicle and type of the vehicle 1) MH-48-AJ-3661 2) MH-18-AK-8420
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. 1) MH-48-AJ-3661 GULAZAR SING SUCHA SING ATPOST-RSS MARKET POWER HOUSE BHILAL DIST DURG (C G)
Name of the owner of the vehicle as it stand on the date of the accident 1) MH-48-AJ-3661 MENLAYN TRANSPORT PVT LTD TATA HOUSEING DEVELOPMENT CO LTD GOODLIGE CHILLAR ROAD PALGHARA VILLAGE BETEDGAON TAL PALGHAR BOISAR DIST-THANE
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. 1) MH-48-AJ-3661 INSURANCE COMPANY NAME- BAJAJ ALLIANZ GENERAL INSURANCE CO LTD BAJAJ HOUSE 291 XTRIUM 4TH FLOOR CHURCH ANDEHRI KURLA ROAD CHAKALA ANDEHRI (E) MUMBAI
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate OG-18-1904-1803-0000424
Action Taken if any, and the result thereof. THE ACCUSED WAS ARRESTED DAR FORM FULLFILL
FIR Download Document 1
MEDICAL CERTIFICATE Download Document 2

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