Accident Detail Receipt
Date And Time 05-Apr-2017 / 12:00 pm
Place of Accident salve shivar on road
CR NO/ TAR No/ SDE NO CR NO 51/2017 IPC ACT 304A 279 MV ACT 184
Name of the Injured/ Deceased BHAIDAS RANGA BILADE
Name of The Hospital to which he/she was removed SHINDKHEDA RURAL HOSPITAL SHINDKHEDA
Number of vehicle and type of the vehicle TRACTOR NO MH-18Z-3195
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. PRAKASH SHRIRAM THAKRE ADD-HATNUR TAL-SHINDKHEDA DIST-JALGAON
Name of the owner of the vehicle as it stand on the date of the accident PRAKASH SHRIRAM THAKRE DATE 5/4/2017
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. --------
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate -------------
Action Taken if any, and the result thereof. CR NO-51/2017
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