Accident Detail Receipt
Date And Time 09-Nov-2017 / 11:15 pm
Place of Accident civil Hospiltal Dhule
CR NO/ TAR No/ SDE NO Shirpur PS CR No 325/17 IPC 304A ,279, 337,338, MV ACT 184
Name of the Injured/ Deceased Bala Machindra Thorat 31 years old At post bodha wada shirpur
Name of The Hospital to which he/she was removed Cottege Hospital Shipur
Number of vehicle and type of the vehicle MP09 HG 7477 Mal Track(Accuesd vehicle)
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. Ajmeri Khan Darab khan At Post Dewli Tahsil Tok dist Devas(MP)
Name of the owner of the vehicle as it stand on the date of the accident Nil
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Nil
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. Fill Up chargeshir to court
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