Accident Detail Receipt
Date And Time 09-Mar-2018 / 12:00 am
Place of Accident Near Village Of Dabhashi, On NH-3, West Side Tal-Shindkheda Dist- Dhule
CR NO/ TAR No/ SDE NO 18/2018 SDE NO- 24/ 24:00 Ipc 304(A), 279,337,338,427 Mv Act- 184, 134/177
Name of the Injured/ Deceased Arjunsing Hindusing Gujar Age- 35, Ad- Harangaon, Tal-Shajapur, Dist- Shajapur
Name of The Hospital to which he/she was removed PHC Shirpur Tal Shirpur Dist- Dhule
Number of vehicle and type of the vehicle 1. Maltruck MP- 09-HG-3727
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. Shakir Khan Abdul Raheman Khan Post- Khachrod, Tal- Aaasta, Dist- Sihor (M.P) New Ad- Gandhinagar Tal- Khajur, Dist- Bhopal Licence No- MP04R-2015-0597044 RTO- BHOPAL
Name of the owner of the vehicle as it stand on the date of the accident Vijay Kumar Keshoram Sharma Ad- 14- Piplia Rao, A.B.Road, 14 Ambika Pura Piplia Rao Indore, Madhya Pradesh- 452001
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. THE NEW INDIA ASSURANCE CO.LTD Govt.of India Division Office- Indore Division Office-II(450800) Indore DO-2,313-316,3RD Floor, Shekar Central Plasiya Square, Indore Madhya Pradesh, 452001
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Policy No- 45080031170100016524 Validity- 14.01.2018 to 13.01.2019
Action Taken if any, and the result thereof. Investigation

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