Accident Detail Receipt
Date And Time 29-Nov-2017 / 5:30 am
Place of Accident On NH- 3 , Near Hotel Sahara ,Dabhashi, Tal Shindkheda Dist Dhule Public Place
CR NO/ TAR No/ SDE NO 100/2017 SDE NO 14 : 13 , IPC 304 (A), 279,337,338 MV ACT 134/177
Name of the Injured/ Deceased Chetan Sanjay Patil Age- 23 At Post Balde Tal- Shirpur Dist- Dhule
Name of The Hospital to which he/she was removed Cottage Hospital Shirpur Dist- Dhule
Number of vehicle and type of the vehicle 1) Motar Cycle - Honda Splendar MH-18-U-3758 2) Unknown Vehicale
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. 1) At Post - Balade Tal Shirpur , Dist- Dhule 2) Unknown-
Name of the owner of the vehicle as it stand on the date of the accident 1) Ajay Panditrao Patil At Post- Balade, Tal Shirpur Dist- Dhule 2) Unknown
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. 1) No Insurance 2) Unknown Vehical
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate No Insurance
Action Taken if any, and the result thereof. Under Investigation

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