Accident Detail Receipt
Date And Time 11-Jun-2017 / 10:00 am
Place of Accident MUMBAI-AGRA NATIONAL HIGHWAY NO.3 NAGAON BARI CHOUFULI BRIDGE ON SERVICE ROAD FRONT OF KESHARANAND LAWN DEOPUR DHULE
CR NO/ TAR No/ SDE NO 62/2017 IPC 279, 337,338, 427 WITH M V ACT 184, 134/177
Name of the Injured/ Deceased INJURED- 1) SHARIF SULTAN FAKIR AGE- 44 RES- NEAR MOGLAI MASHID DHULE 2) ASIF ANIS SHAH AGE- 27 RES- NEAR MOGALAI MASJID DHULE 3) JUNAID AKHATAR ABDUL HAMID AGE- 24 RES- AZADNAGAR DHULE
Name of The Hospital to which he/she was removed SARAH HOSPITAL VADAJAI ROAD DHULE
Number of vehicle and type of the vehicle 2 VEHICLE TYPE- 4 WHEELER 1) MH/25/B/6091 TATA 407 TEMPO 2) MH/05/AS/9819 CAR SWIFT MARUTI CAR
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. ACCUSED TATA 407 TEMPO DRIVER NAME- SHAIKH SALIM SHAIKH KARIM AGE-52 RES.- HOME NO 3641 SAKRI NAKA SAKRI ROAD DHULE
Name of the owner of the vehicle as it stand on the date of the accident NIHAL AHMED MOSHABAN ANSARI
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. CHOLA MS GENERAL INSURANCE
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate POLICY NUMBER- 3379/01678257/000/00 VALIDITY- FROM 20/03/2017 TO 19/03/2018
Action Taken if any, and the result thereof. ACCUSED GIVE NOTICE CRPC 41

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