Accident Detail Receipt
Date And Time 21-Jun-2017 / 7:30 am
Place of Accident Chhadwel to nanadurbar way to siband village near
CR NO/ TAR No/ SDE NO 50/2017
Name of the Injured/ Deceased Gopichand raamu bagul, at. Vitave, tal. Sakri, dist. Dhule
Name of The Hospital to which he/she was removed Chivil hospital nandurbar
Number of vehicle and type of the vehicle Motar cycal mh 39 c 6972
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. Gopichand raamu bagul, at. Vitave, tal. Sakri, dist. Dhule
Name of the owner of the vehicle as it stand on the date of the accident Gopichand raamu bagul, at. Vitave, tal. Sakri, dist. Dhule
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 Nil
Action Taken if any, and the result thereof. Abett final

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