Accident Detail Receipt
Date And Time 16-Mar-2018 / 5:00 am
Place of Accident MUMBAI-AGRA NATIONAL HIGHWAY NO. 03 KUNDANE FATA DEOPUR DHULE
CR NO/ TAR No/ SDE NO 47/2018 IPC 304(A), 279, 337,427 WITH MV ACT 184
Name of the Injured/ Deceased DECEASED- PAPPU KACHARUJI JATAV AGE-46 RES- KHANAPURA TAH. DIST. MANDSAUR (M.P.)
Name of The Hospital to which he/she was removed CIVIL HOSPITAL DHULE
Number of vehicle and type of the vehicle 1 SIX WHEELER EICHER NO- MP/14/HC/6777
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. DRIVER NAME- PAPPU LACHARUJI JATAV AGE-46 RES- KHANAPURA TAH.DIST. MANDSAUR (M.P)
Name of the owner of the vehicle as it stand on the date of the accident SAI BABA FRUIT COMPANY MR LUCKY MULCHANDANI 08 INDUSTRIAL ARIA NEEMUCH ROAD MANDSAUR (M.P.)
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. THE NEW INDIA ASSURANCE CO. LTD ADD- MADURAI DO 3 (730300) SHARON BUILDING 161-A EAST VELI STREET, MUDRAI, TAMILNADU
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate POLICY NUMBER- 73030031170300020127 VALIDITY- 19/01/2018 TO 18/01/2019
Action Taken if any, and the result thereof. ACCUSED ARE DECEASED IN ACCIDENT

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