Accident Detail Receipt
Date And Time 22-Jan-1918 / 9:30 pm
Place of Accident Sakvad Place Sakvad to shirpur Tal shirpur Dist.dhule
CR NO/ TAR No/ SDE NO Shirpur PS Cr No- 19/2018 IPC 279,337,338,427 M V Act.184/177
Name of the Injured/ Deceased Sukadeo Namadeo Bhil Age 45 2. Ravindra Bhavrao Bhil 3.Magesh Viju Bhil 4. Dilip Bhaidas Bhil 5. Amrut Bhil all Add- Sakvad Tal. Shirpur Dist.dhule
Name of The Hospital to which he/she was removed Cottage Hospital shirpur Dist.dhule
Number of vehicle and type of the vehicle Traktar MH-34-AP-2551
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. Nitin Yuvraj Bhil Add- Utavad Tal Shirpur Dist.dhule RTO- NILL L NO- NILL VALID- Nill
Name of the owner of the vehicle as it stand on the date of the accident Bharat Santosh Chaudhari A/P Near Vasudeo baba mamnor Vidhaya Vihar Colony Shirpur dist.dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. United India Insurance company limited add- Shri dinesh complex agra road deopur dhule maharashtra
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 2313003117p114643242 valid-13/01/2018 to 12/01/2019
Action Taken if any, and the result thereof. .

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