Accident Detail Receipt
Date And Time 07-Jan-2018 / 5:30 am
Place of Accident Chinchwar Area Chinchwar- Boris Road Near by guarilal Patil filed distance from songir police station 45 k.m.
CR NO/ TAR No/ SDE NO 6/2018 IPC 279,429, MVAct 184,134/177
Name of the Injured/ Deceased Buffelo
Name of The Hospital to which he/she was removed No
Number of vehicle and type of the vehicle Pick up Van MH-18 M 2599
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. --
Name of the owner of the vehicle as it stand on the date of the accident --
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. --
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate --
Action Taken if any, and the result thereof. --

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