Accident Detail Receipt
Date And Time 23-Dec-2017 / 5:30 am
Place of Accident Nandane Area Sawai mukti- Nandane phata near by uttam Aba mali field distance from songir police station western side 10 K.M .
CR NO/ TAR No/ SDE NO 145/2017 ipc 304(A),279,427 MVACT 184
Name of the Injured/ Deceased 1) Death - Pankaj Premlal jadhav age 27 at post nandane dist dhule
Name of The Hospital to which he/she was removed Doctor Rohan Kulkarni Deore Hospital dhule
Number of vehicle and type of the vehicle Two Wheeler MH-18 BB 3478
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. Pankaj Premlal jadhav age 27 at post Nandane tal dist dhule
Name of the owner of the vehicle as it stand on the date of the accident --
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. Case Registerd Pankaj Premlal jadhav
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