Accident Detail Receipt
Date And Time 09-May-2017 / 2:05 pm
Place of Accident chimthana gaon bus stand near
CR NO/ TAR No/ SDE NO CR NO-68/2017IPC-279 337 338 427 MV-184
Name of the Injured/ Deceased 1)CHUNILAL SITARAM JADHAV 2)RAMESH SITARAM JADHAV
Name of The Hospital to which he/she was removed SIDHESWAR HOSPITAL DHULE
Number of vehicle and type of the vehicle 1)MOTOR CYCLE NO. MH-39-3846 2)ST BUS
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. CHUNILALA SITARAM JADHAV
Name of the owner of the vehicle as it stand on the date of the accident 8/5/2017
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-68/2017
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