Accident Detail Receipt
Date And Time 26-Dec-2017 / 10:30 am
Place of Accident Songir Area Songir- Dondaicha road near by Sameshwar temple distance from songir police station western side 2 K.M.
CR NO/ TAR No/ SDE NO 143/2017 IPC 279,427,MVACT 184
Name of the Injured/ Deceased Dinesh Babu more At Post Subhash nagar warkhedi road dhule
Name of The Hospital to which he/she was removed Civil Hospital Dhule
Number of vehicle and type of the vehicle 1) Max Pickup MH-18 L 4605 2) Bolero Max MH-18 AA 3488
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. Nilesh Brijesh gurav age-23 at dondaicha tal dist dhule
Name of the owner of the vehicle as it stand on the date of the accident Nilesh Brijesh gurav age 23 dondaicha 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. --
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate --
Action Taken if any, and the result thereof. attended Dhule court no.2
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