Accident Detail Receipt
Date And Time 17-May-1917 / 11:00 am
Place of Accident Shirpur T-Point Shirpur bus Stand road 200ft. desstion Sprd Brakar point Tal shirpur dist.dhule (MS)
CR NO/ TAR No/ SDE NO Shirpur PS CR NO- 188/2017 IPC-304(A),279,337,338, M V Act.184
Name of the Injured/ Deceased Dilip Chhagan Vanjari Age-30 Add- hadakhed
Name of The Hospital to which he/she was removed Cottage Hospital Shirpur Dist.Dhule (ms)
Number of vehicle and type of the vehicle Mahendra Max kali pili MH-18/W/5681
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. Kishor Kashinath Gaykawad Add -Sangvi Tal shirpur Dist Dhule RTO- D L NO- Valid-
Name of the owner of the vehicle as it stand on the date of the accident kashinath Rama Gaykawad Aded- Sangavi Tal shirpur
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. The Oriental insurance company limited Add- rajpal complex near new bus stand A.B.Road Sendhwa Khandwa (madhya pradesh)
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 153590/31/2018/23 valid-11/04/2017 to mednight of 10/04/2018
Action Taken if any, and the result thereof. invetigetion
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