Accident Detail Receipt
Date And Time 13-Mar-2017 / 2:15 pm
Place of Accident OLD MUMBAI AGRA ROAD FRONT OF DEORE HOSPITAL DEOPUR DHULE
CR NO/ TAR No/ SDE NO 23/2017 IPC 304 (A), 279, 337, 338 WITH M V ACT 184, 134/177
Name of the Injured/ Deceased DECEASED- ARVIND PRATAP UPADHE AGE-36 RES. PLOT NO 168 HAJARE COLONY DEOPUR DHULE
Name of The Hospital to which he/she was removed CIVIL HOSPITAL DHULE
Number of vehicle and type of the vehicle MOTOR CYCLE NO.- MH/18/AV/9932
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. SACHIN DAGA RATNAPARKHI AGE- 25 RES.- PLOT NO . 24 HAJARE COLONY DEOPUR DHULE
Name of the owner of the vehicle as it stand on the date of the accident JAGATRAO VEDU RATNPARKHI AGE-52 RES. PLOT NO. 24 HAJARE COLONY DEOPUR DHULE
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. ICICI LOMBARD MOTOR INSURANCE PRABHADEVI MUMBAI 400025
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate POLICY NUMBER- 3005/2010816752/00/0000002608 VALIDITY- 05/12/2016 TO 04/12/2018
Action Taken if any, and the result thereof. ACCUSED GIVE NOTICE CRPC 41

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