Accident Detail Receipt
Date And Time 21-Jan-2018 / 5:00 pm
Place of Accident In Nardana Mumbai Agra National Highway No.3 Near Hotel Dhanraj Tal Shindkheda Dist Dhule.
CR NO/ TAR No/ SDE NO 06/2018 IPC 279,337,338,427 MVAct 134/177
Name of the Injured/ Deceased Rajendra Onkar Marathe Age 55 At Ajande Khu. Tal Shindkheda Dist Dhule.
Name of The Hospital to which he/she was removed Dr Mahale Accident Hospital Malegaon Road Dhule
Number of vehicle and type of the vehicle Goods Vehicle MP 09 HH 1627 Motor Cycle MH 18 AL 4316
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. Juwan sing Kadwa Age 30 At Bhikarkhedi Tal Shegaon Dist Khargon MP
Name of the owner of the vehicle as it stand on the date of the accident Mrs Sangeeta Sanjay Sing C/O Mamta Road lines 04 Samrat Ashok Nagar 2nd Floor Anjani Plaza Bhanwarkua Road Indore.
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 Insurance Company Ltd.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Policy No. 45130031170100002323
Action Taken if any, and the result thereof. Nardana Police Station 5 CR No. 06/18 IPC 279,337,338,427 MVAct 134/177

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