Accident Detail Receipt
Date And Time 19-Dec-2017 / 12:00 pm
Place of Accident ON NATIONAL HIAGWAY NO 3 ,NEAR NATWADE TAL SHIRPUR DIST DHULE
CR NO/ TAR No/ SDE NO 03/2018 IPC 279,338,427,R/W MV ACT 184,134/177
Name of the Injured/ Deceased 1) TULSHIRAM BALIRAM PAWRA AGE 20 ADD- KHADKYA TAL SENDHAWA DIST BADWANI M.P 2) SAYSING KUWARSINGH PAWRA AGE 14 ADD GVHADI TAL SENDHWA M.P
Name of The Hospital to which he/she was removed COTTAGE HOSPITAL SHIRPUR , SADGURU HOSPITAL SHIRPUR,
Number of vehicle and type of the vehicle 1) MP 09 NH 7463
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. NO DOCUMENT
Name of the owner of the vehicle as it stand on the date of the accident NO DOCUMENT
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. NO DOCUMENT
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate NO DOCUMENT
Action Taken if any, and the result thereof. FILLUP CHARGE SHEEAT COURT
FIR COPY Download Document 1
PANCHNAMA COPY Download Document 2
MEDICAL CERT. Download Document 3

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