Accident Detail Receipt
Date And Time 06-Jun-2017 / 4:00 pm
Place of Accident shindkheda gaon near patan chaufili
CR NO/ TAR No/ SDE NO CR NO 85/2017 IPC ACT-279 337 338 MV-184 134/177
Name of the Injured/ Deceased PTADIP SHAMRAO BHADANE ADD-AMLTHE TAH-SHINDKHEDA DIST-DHULE
Name of The Hospital to which he/she was removed HIRE MEDICAL COLLEGE DHULE
Number of vehicle and type of the vehicle 1)BOLERO NO. MH-39D-1836
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. RAJESH NARAYAN BHAVSAR ADD-BHAVSAR GALLE SHADA DIST-NANDURBAR LICENSE NO-MH-3920080000233
Name of the owner of the vehicle as it stand on the date of the accident 23/3/2017
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-85/2017
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