Accident Detail Receipt
Date And Time 23-Jan-2018 / 7:00 pm
Place of Accident Near chakadu forest hill ,at sardar pada
CR NO/ TAR No/ SDE NO 12/2018 IPC 304a ,279,427 r/w MV act 184
Name of the Injured/ Deceased Yesram tembharya pawara (dead)age 30 ekkavya pada boradi tal shirpur
Name of The Hospital to which he/she was removed Shirpur cottege hospital shirpur
Number of vehicle and type of the vehicle Tractor mh 18 z 7390
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. Yesram thembhrya pawara (driver) eklavya pada borade tal shirpur dist dhule
Name of the owner of the vehicle as it stand on the date of the accident Indram Tembharya pawara age 45 add. Eklavya pada boradi tal shirpur
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 company limited new Delhi
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 26168576 Valid 22/11/18
Action Taken if any, and the result thereof. File chragshit to court
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