Accident Detail Receipt
Date And Time 06-May-2018 / 8:00 am
Place of Accident Arthe to chandpuri road tal shirpur dist.dhule
CR NO/ TAR No/ SDE NO cr no 110/2018 shirpur ps 304 A ]279]337]427 MVACT 184]134/177
Name of the Injured/ Deceased kalushing Ranya padavi 2. darkya jatrya more
Name of The Hospital to which he/she was removed cottage hospital shirpur and hire medical colege dhule and civil hospital dhule
Number of vehicle and type of the vehicle Tata 909 MH 18 Z 1278
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. Vasudeo Fula chaudhari age50 add- sawal dukti tal shindkheda dist dhule l no-mh1819920000268 RTO- Dhule Valid-31/10/2018
Name of the owner of the vehicle as it stand on the date of the accident Vasudeo Fulchan dhaudhari add-40 adarsh nagar shirput dist.dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. IFFCO TOKIO GENERL INSURANCE CO.LTD Near sher-e-punjab hotal aach knadil chowk dule maharashtra
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 1-k6cjmor p400 26245429 30/11/2017 to 29/1/018
Action Taken if any, and the result thereof. in
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