Accident Detail Receipt
Date And Time 19-Nov-2017 / 7:30 pm
Place of Accident Vaghadi T point Aakash Dardan Face road Shirpur dist dhule
CR NO/ TAR No/ SDE NO shirpur PS CR NO-361/2017 IPC 304A, 279,337,338, MV Act-184, 134/177
Name of the Injured/ Deceased Rangrao Rayaram Patil age 70 Add- wagadi shirpur dist dhule maharashtra
Name of The Hospital to which he/she was removed cottage hospital and civil hospital dhule and Indira hospital shirpur and K E M Hospital mumbai
Number of vehicle and type of the vehicle Cruser MH-28-V-2965 MH-39-D-6298
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. 1.Ravindra Sitaram Patil Age-47 waghadi Tal shirpur dist dhule maharashtra 2.RTO- Dhule 3.L NO- ------ 4.vilidi ---------
Name of the owner of the vehicle as it stand on the date of the accident Mahendra Bhaidas Patil Add-28 mukesh bhai nagar shirpur dist.dhule maharashtra
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. The oriental Insurance company Add-first floor pushpanjali morket opp manohar chitra Mandir agra road near B I Dhule maharashtra
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 182600/31/2017/6282 14/01/2017to 13/01/18
Action Taken if any, and the result thereof. .
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