Accident Detail Receipt
Date And Time 16-Nov-2017 / 3:15 pm
Place of Accident Waghadi village pleace Waghadi to wadi boradi road /Near Rajesh arun hoshi farm by Tal.shirpur dist.dhule
CR NO/ TAR No/ SDE NO shirpur ps cr no-23/2018 IPC-304 A,279,337,338,427, M V Act.134/177
Name of the Injured/ Deceased 1. Anarsing Revasing Parmar (pavra) (Death)
Name of The Hospital to which he/she was removed Cottage Hospital shirpur Dist.dhule (MS)
Number of vehicle and type of the vehicle M/C- MH-18/X/3820
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. Denesh Rajasing Pavra(Kirade) Age- //Add - Vagara Tal-Pansemal . Dost-Badwani (MP) RTO- NILL D L NO- NILL Valid- NILL
Name of the owner of the vehicle as it stand on the date of the accident Ganiram kalusing Pavra Age-35 Add- Var[ira Ta; {amse,a; Dost- Nadvamo (mp)
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 18/09/2015 to 07/09/2016
Action Taken if any, and the result thereof. INVIGETION
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