Accident Detail Receipt
Date And Time 11-Aug-2017 / 4:30 pm
Place of Accident NEAR HADAKHED GAON, ON MUMBAI TO AGRA HAIGWAY ROAD, RTO CHECK POST
CR NO/ TAR No/ SDE NO 65/2018 IPC 304A,279,427,R/W MV ACT 184
Name of the Injured/ Deceased LAXMAN KISAN DESHMUKH AGE 38 ADD- SANGVI TAL SHIRPUR DIST DHULE
Name of The Hospital to which he/she was removed COTTAGE HOSPITAL SHIRPUR, DHULE
Number of vehicle and type of the vehicle 1) HR 55 W 7332 MALTRUCK ( ACUSE VEHICLE)
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. MUKESH BANSILAL RAJPUT ADD BRMAD TAL RAMGAD DIST ALWAR RAJSTHAN
Name of the owner of the vehicle as it stand on the date of the accident MUKSEH BANSILAL RAJPUT ADD BRMAAD TAL RAMGAD DIST ALWAR RAJSTHAN
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. NO DOCUMAENT
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. FILL UP CHARGSHEET TO COURT
FIR COPY Download Document 1
PANCHNAMA COPY Download Document 2
PM NOTES COPY Download Document 3

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