Accident Detail Receipt
Date And Time 08-Jan-2018 / 4:30 pm
Place of Accident Bharwade To Chandpuri Raod
CR NO/ TAR No/ SDE NO Shirpur PS CR.NO-8/2018 IPC 304A ,279
Name of the Injured/ Deceased Gopal Rajendra Patil (Nikam) 23 years old AT Post Hingoni Tal.Shirpur vishal Pramod Patil 21 years old At Post Shigave Tal.Shirpur Arjun Khandu Bhil 18 years old At post sakvad Tal.Shirpur
Name of The Hospital to which he/she was removed Cottege Hospitl Shirpur
Number of vehicle and type of the vehicle Tractor No MH 39 N 0897
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. Rakesh Daga Patil At post Vaijali Tal.Shahada Dist Nandurbar
Name of the owner of the vehicle as it stand on the date of the accident Rakesh daga patil at post Vaijali Tal shahada Dist Nandurbar
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. chola Ms Insurance Company Limited Add- Nandurbar
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. The Accused was
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