Accident Detail Receipt
Date And Time 24-Jun-2017 / 6:00 pm
Place of Accident Uparpind village Tal.Shirpur Dist. Dhule
CR NO/ TAR No/ SDE NO shirpur ps cr no-198/2017 IPC-279,427,429,
Name of the Injured/ Deceased Two Animal 1. goav 1. goeat
Name of The Hospital to which he/she was removed nill
Number of vehicle and type of the vehicle Annon
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. nill
Name of the owner of the vehicle as it stand on the date of the accident nill
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. nill
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate nill
Action Taken if any, and the result thereof. A final

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