Accident Detail Receipt
Date And Time 07-May-2018 / 12:45 pm
Place of Accident Gavhane Shivar, Behind Punjabi Dhaba, On National Highway No.3 Tal. Shindkheda Dist. Dhule.
CR NO/ TAR No/ SDE NO No.5 CR No. 28/2018 IPC 304A, 279, 337, 338, 427 MVAct 184, 134/177
Name of the Injured/ Deceased Saurav Nandkishor Ahirrao Age 27 At. Pahure Tal. 40 gaon Dist. Jalgaon. (DEAD)
Name of The Hospital to which he/she was removed Primary Health Centre, Nardana Tal. Shindkheda Dist Dhule
Number of vehicle and type of the vehicle 1. Unknown vehicle 2. Bajaj Pulser Motor Cycle No. MH 15 CA 1853
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. Unknown.
Name of the owner of the vehicle as it stand on the date of the accident Unknown.
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Unknown.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Unknown.
Action Taken if any, and the result thereof. No.5 CR No. 28/2018 IPC 304A, 279, 337, 338, 427 MVAct 184, 134/177

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