Accident Detail Receipt
Date And Time 15-Jan-2018 / 11:00 am
Place of Accident Shirpur to Savalde Road ,Waking Raod Kharde village Tal shirpur Dist.Dhule (MS)
CR NO/ TAR No/ SDE NO Shirpur ps CR NO-35/2018 IPC 304(A)279,337,338 M V Act.184/177
Name of the Injured/ Deceased Vinod Prakash Bhil(badgujar) Age-25 Add-KhardeGujar Tal shirpur Dist,Dhule(MS)
Name of The Hospital to which he/she was removed Cottage Hospital Shirpur Dist.Dhule (MS)
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. Annon
Name of the owner of the vehicle as it stand on the date of the accident Annon
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. nil
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate nil
Action Taken if any, and the result thereof. A fainal
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