Accident Detail Receipt
Date And Time 10-Jan-2018 / 5:30 am
Place of Accident Songir Area Munbai- Agra National Highway 03 Near Songir Toll naka distance from Songir police Station 3 K.m.
CR NO/ TAR No/ SDE NO 8/2018 IPC 279,337,427 MVAct 184
Name of the Injured/ Deceased 1) Avinash Vasant Patil age 22 2) Vasant Sitaram shirshat
Name of The Hospital to which he/she was removed Songir Gramin Hospital Songir Tal Dist Dhule
Number of vehicle and type of the vehicle 1) Hero honda passhan pro MH-19 CC 5644 2) Truck no. HR 55 U 2030
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. Krishnamurarari Bhajajlal arrest him 12/01/2018 time 12.21

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