Accident Detail Receipt
Date And Time 08-Sep-2017 / 3:33 pm
Place of Accident On Mumbai Aagra Mahamarg NO- 03, Near Kalmadi Fata Tal Shinkheda , Dist- Dhule
CR NO/ TAR No/ SDE NO 70/2017 SDE NO- 46/15:33 IPC 279,337,338,427 MV Act- 184
Name of the Injured/ Deceased 1. Ashok Kanji Vaishnav Age -21 (Injured Person) A/P- Pawar Bangla , Maparvadi Road Lonikhurde, Rahata Dist- Ahamadnagar
Name of The Hospital to which he/she was removed 1) P.H.C Nardana Tal- Shinkheda Dist- Dhule 2) Pravara Rural Hospital Loni Tal- Rahata, Dist Ahamadnagar
Number of vehicle and type of the vehicle Luxary Bus :- MP-30- P- 0813
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. Drivar Name :- Ramcharan Chotulal Dube Age- 47 A/P- Gopalpura, Kent (M.P) Licence No :- MP08R-2015-0017070 RTO:- Guna, (M.P)
Name of the owner of the vehicle as it stand on the date of the accident HariOm Dube A/P- Jamana Road, Bhind (M.P)
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 Limited Division Office :- Indore 105 Shagun Complex, Vijay Nagar A.B Road Indore (M.P)
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate policy No:- 45070031160100009776 Validity :- 03.02.2016 to 02.12.2017
Action Taken if any, and the result thereof. Charge Sheet Submit

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