Accident Detail Receipt
Date And Time 13-Jan-2018 / 8:00 pm
Place of Accident shirpur to shahada road varul please Suresh Madhavrao Salukhe thise formar near
CR NO/ TAR No/ SDE NO Shirpur PS CR No.13/2018 IPC-304 A,279,337,338 427, MV Act-184,134/177
Name of the Injured/ Deceased 1.Guddy Bhishan pavra 2.Nana(Nhanu)Chapdya pavra 3.Rijya chapdya pavra
Name of The Hospital to which he/she was removed Cottage hospital shirpur dist.dhule maharashtra
Number of vehicle and type of the vehicle Track MH-13-R-1989 M/C MH-18-U-5029
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. Arvind yashwant khomane add-A/P- jalgaon supe tal baramati pune RTO- Baramati pune L.NO-MH-42 20100000022 VALID tILL-21/04/2028 NT
Name of the owner of the vehicle as it stand on the date of the accident Satish Sukhdeo hagare a/p hagarewadi shirsatwadi tal -indapur dist pune maharashtra 413106
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Reliance commercial vehicle package policy (GCV)- ADD-Heritage house ground floor - ramabai ambedkar road pune maharashtra
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 170121723340024204 24oct-2017 to 23-oct-2018
Action Taken if any, and the result thereof. A-bet
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