Accident Detail Receipt
Date And Time 01-Oct-2017 / 11:30 pm
Place of Accident GANGAPUR VILLAGE NATIONAL HIGHWAY NO 6 RAJKAMAL HOTEL ON BEHIND
CR NO/ TAR No/ SDE NO CR NO 119/2017 IPC 304(A) 279,337,427, MVA 184,134/177
Name of the Injured/ Deceased PRADIP SAHEBARAO SHINDE 47 YEAR OLD AT POST- PRATAPUR TAL-SAKRI DIST DHULE
Name of The Hospital to which he/she was removed RURAL HOSPITAL DHULE
Number of vehicle and type of the vehicle 1) GJ-05-JL-2168 2) MH-18-EV-8372
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) GJ-05-JL-2168 DRIVER NAME - NAVANIT BHAI GORADHANBHAI SANTOKI 30 YEAR OLD AT POST- SANAM APPARTMENT PUNA MUMABAI ROD PUNAGAON SURAT GUJARAT 2) MH-18-EV-8372 DRIVER NAME- PRADIP SAHEBARO SHINDE 47 YEAR OLD TAL-SAKRI DIST-DHULE
Name of the owner of the vehicle as it stand on the date of the accident 1) GJ-05-JL-2168 OWNER NAME- DENISHBHAI HARIBHAI KAMANI ADDRESS- A-404 LAMXI PALACE APPT CHHITU NAGAR SOC NR SITA NAGARA CHAUK PUNA GAM SURAT GUJARAT
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. GJ-05-JL-2168 INSURANCE COMPANY - ICICI LOMBARD COMPANY LTD ADDRESS- 414 VEER SAVARAKAR MARGA NEAR SIDHIVINAYAK TEMPLE PRABHADEVI MUMBAI
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 3001/HI-10515656/00/000
Action Taken if any, and the result thereof. THE ACCUSED WAS ARRESTED ON DATE 05/10/2017
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