Accident Detail Receipt
Date And Time 25-Sep-2017 / 4:30 pm
Place of Accident NATIONAL HIGHWAY NO 6 SURAT NAGAPUR DAHIVEL VILLAGE SHIVAR SAI BABA PETROL PUMP
CR NO/ TAR No/ SDE NO CR NO 114/2017 IPC 304(A) 279,337,427 MVA 184,134/177
Name of the Injured/ Deceased 1) BABULAL KASHIRAM MALI 71 YEAR OLD RAA-ROHOD TAL-SAKRI DIST-DHULE 2) KOLSHIRAM SHIVAJI SABALE 65 YEAR OLD AT POST ROHOD TAL-SAKRI DIST-DHULE
Name of The Hospital to which he/she was removed 1) RURAL HOSPITAL SAKRI 2) CIVIL HOSPITAL DHULE
Number of vehicle and type of the vehicle 1) RJ-07-JD-2250 2) MH-18-AL-4926
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) RJ-07-JD-2250 DRIVER NAME - UDYASING KALYAN SINGH RAJPUT ADDRESS- ATPOST- BETINA TAL-BANIYANA DIST-JAISALMER (RAJSTAN) 2) MH-18-AL-4926 BDRIVER NAME-BABULAL KASHIRAM GAVLI ADDRESS- PLOT NO 45 MAHAVIR BHAWAN JAVAL PIMPALNR TAL SAKRI DIST-DHULE
Name of the owner of the vehicle as it stand on the date of the accident RJ-07-JD-2250 OWNER NAME- SH KARNAPAL SING SAMUNDER SINGH RATHORE ADDRESS- ANTODYA NAGARA DIST -BIKANER RAJSTAN
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. RJ-07-JD-2250 INSURANCE COMPANY- NATIONAL INSURANCE COMPANY LTD ADDRESS - 3 MIDDLETON STREET POST POX NO 9229 KOLKATA
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 380500/31/17/6300000732
Action Taken if any, and the result thereof. THE ACCUSED WAS ARRESTED
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