Accident Detail Receipt
Date And Time 20-Dec-2016 / 9:30 pm
Place of Accident NEAR DATTA MANDIR CHOUK FRONT OF HIM HOTEL DEOPUR DHULE
CR NO/ TAR No/ SDE NO 41/2017 IPC 279, 337,338,427 WITH M V ACT 184, 134/177
Name of the Injured/ Deceased INJURED- CHITRMADHU MADHUKAR BHADANE AGE-47 RES.- PLOT NO. 65 SADGURU COLONY DEOPUR DHULE
Name of The Hospital to which he/she was removed DEORE HOSPITAL DEOPUR DHULE
Number of vehicle and type of the vehicle 1) SCOOTY MOTOR CYCLE NO- MH/18/AE/0589 2) BULLET MOTOR CYCLE NO.- MH/18/AS/7866
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. SHAHURAJ MAHENDRA PATIL AGE-26 RES.- PLOT NO 45 BADGUJAR COLONY DEOPUR DHULE
Name of the owner of the vehicle as it stand on the date of the accident SHAHURAJ MAHENDRA PATIL
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. NOT KNOWN
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate NOT KNOWN
Action Taken if any, and the result thereof. ACCUSED GIVE NOTICE CRPC 41

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