Accident Detail Receipt
Date And Time 26-Nov-2017 / 9:25 am
Place of Accident Chhadvel to titane way
CR NO/ TAR No/ SDE NO 108/2017
Name of the Injured/ Deceased Sharad bhuru ahire, age. 44, at.aambemohar, tal. Sakri, dist. Dhule
Name of The Hospital to which he/she was removed PHC Jaitane, tal. Sakri, dist.dhule
Number of vehicle and type of the vehicle Pickup mh 39 c 8950
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. Imran raju shekh, age. 28, at. Khanbaara, tal. Navapur, dist. Nandurbar
Name of the owner of the vehicle as it stand on the date of the accident Fhiroj arun bagvan, at. Khandbaara, tal. Navapur, dist. Nandurbar
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. United indian insurance company limited
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 01.02.2017 to 31.01.2018
Action Taken if any, and the result thereof. Court pending

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