Accident Detail Receipt
Date And Time 23-Nov-2017 / 7:00 am
Place of Accident Titane villege near nandurbar way, tal. Sakri, dist. Dhule
CR NO/ TAR No/ SDE NO 105/2017 304 (a),279, 337,338, mv act 184
Name of the Injured/ Deceased Pandurang hanumant pawar, age. 46, at. Rupainagar, sakri, dist. Dhule
Name of The Hospital to which he/she was removed Gramin rugnalay sakri, dist. Dhule
Number of vehicle and type of the vehicle Tata compny indigo GJ 15 AD 2503
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. License no. :- mh18 20140029860 valid. 07.12.2034 Pankaj vilash shewale, age. 22, at. Dighave, tal. Sakri, dist. Dhule
Name of the owner of the vehicle as it stand on the date of the accident Vilash jagannath sewale, at. Dasera colony, songhad, tal. Songhad, dist. Tapi
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. The new indian assurance
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Number of insurance policy/ insurance:- 1 Date of validity of the insurance policy/ insurance certificate :- 13.12.2016 to 12.12.2017
Action Taken if any, and the result thereof. Invistigation

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