Accident Detail Receipt
Date And Time 29-Dec-2017 / 7:00 pm
Place of Accident Brhamanwel to dahiwel to jambhore way
CR NO/ TAR No/ SDE NO 5/2018
Name of the Injured/ Deceased Gotiram murlidhar thakre, age. 25, at. Bandharpada, tal. Sakri, dist. Dhule
Name of The Hospital to which he/she was removed Chivil hospital nanadurbar
Number of vehicle and type of the vehicle Hiro honda cd 100 motar cycal mh 18 Q 5146
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. Gotiram murlidhar thakre, age. 25, at. Bandharpada, tal. Sakri, dist. Dhule
Name of the owner of the vehicle as it stand on the date of the accident Pramod sadashiv nagare, at. Vardhman nagar, nandurbar
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Nill
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Nill
Action Taken if any, and the result thereof. Abett final
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