Accident Detail Receipt
Date And Time 17-Apr-2018 / 1:30 pm
Place of Accident NEAR JAHIND COLONY IN FRONT OF SAI ICHHA APARTMENT GITA NAGAR ROAD DEOPUR DHULE
CR NO/ TAR No/ SDE NO CR NO 57/2018 IPC 279,337,338,427 MV ACT 184,134/177
Name of the Injured/ Deceased JAGDISH KASHINATH MAHAMJAN AGE.43 ADD.SAI KRUPA COLONY STEDIUM ROAD DEOPUR DHULE
Name of The Hospital to which he/she was removed DEORE HOSPITAL GANPATI MANDIR ROAD DEOPUR DHULE
Number of vehicle and type of the vehicle 1 TWO WHEELER MH 18 AR 0812
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. NILL
Name of the owner of the vehicle as it stand on the date of the accident KISHOR KASHINATH JADHAV
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. BAJAJ ALLINZ GENERAL INSHURANCE COMPANY LTD.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate OG-18-2002-1802-00014722
Action Taken if any, and the result thereof. CR NO.57/2018 IPC 279,337,338,427 MV ACT 184,134/177

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