Accident Detail Receipt
Date And Time 22-Jul-2017 / 5:30 am
Place of Accident Nawlane Area Mehergaon - Boris Road distance from songir police station 45 km
CR NO/ TAR No/ SDE NO 72/2017 304(A),279,337,427,338, mvact 184
Name of the Injured/ Deceased 1) Death Jibhau Hiraman Bagul age-28 AT Post Nawlane Tal Dist Dhule
Name of The Hospital to which he/she was removed Civil Hospital Dhule
Number of vehicle and type of the vehicle 1) Two Wheeler Bajaj CT 100 MH-18 /AV 7271 2) Hero Honda MH-18/B 2412
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. Bhaidas Shantaram Bagul age 42 at post Nawlane tal dist dhule
Name of the owner of the vehicle as it stand on the date of the accident Sahebrao Zenda Suryawanshi age 43 at post Nawlane tal dist dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Bajaj Allinz general com Nashik
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate OG-17-2003-1802-000/1407
Action Taken if any, and the result thereof. Bhaidas Shantaram Bagul age -42 arrest 4/08/2017 Time 12.36
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