Accident Detail Receipt
Date And Time 24-Apr-2018 / 4:00 am
Place of Accident Nardana shivar Melanie bypass service road
CR NO/ TAR No/ SDE NO CR No. 27/2018 IPC 304(A),279,337,338,427 MV act 184,128/177
Name of the Injured/ Deceased Death person- Bharat Madhavrao Mali, age 32, Mohadi pra. Dangri, Tal. Dist Dhule Injured person- Samadhan Ashok Biari (Mali) age- 19, Mohadi pra Dangri, Tal Dist Dhule
Name of The Hospital to which he/she was removed Civil Hospital, Dhule
Number of vehicle and type of the vehicle Hero Hindi Dawn motorcycle No. MH 19 M 7332
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. Viswas urf Samadhan Suklal Bagul, age 34, Mohadi pra Dangri, Tal- Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident Bharat Madhavrao Mali, Mohadi pra Dangri, Tal- Dist Dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. IFFCO-TOKIO General Insurance Co LTD, Read. Office IFFCO sadan C1 Dist. Centre, saket, New Delhi- 110077
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 27 AAACI7573H1ZC 29/01/2018 to 28/01/2019
Action Taken if any, and the result thereof. CR No. 27/2018 IPC 304(Aq)

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