Accident Detail Receipt
Date And Time 02-Mar-2018 / 7:00 pm
Place of Accident In Pimprad Between Nardana To Hol Road Near Nirmal Aqua Tal Shindkheda Dist Dhule.
CR NO/ TAR No/ SDE NO 17/2018 IPC 279,337,338,427 MVAct 184,134/177
Name of the Injured/ Deceased 1. Vyankat Sitaram Borse Age 58 At Sidharth Nagar Shindkheda Dist Dhule. 2. Mahendra Ramesh Vande.
Name of The Hospital to which he/she was removed Civil Hospital Dhule And Surat Hospital.
Number of vehicle and type of the vehicle Car No MH 43 BK 5133 And Motor Cycle No MH 19 CM 3044
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. Pramod Puran Bagul Age 51 At Kamkheda Tal Shindkheda Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident Bhushan Shriram Patil At. Sonewadi Tal Shindkheda Present add. New Mumbai
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. HDFC ERGO General Insurance Company Limited
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 2311202061885300000
Action Taken if any, and the result thereof. Nardana Police Station CR No 17/2018 IPC 279,337,338,427 MVAct 184,134/177

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