Accident Detail Receipt
Date And Time 05-May-2018 / 5:00 am
Place of Accident Shirpur to shahada Road Vikharan village Tal shirpur dist dhule
CR NO/ TAR No/ SDE NO shirpur cr no 112/2018 IPC 279.337.338.427. MV ACT 184.134/177
Name of the Injured/ Deceased Kishor Vasudeo palil Linabai Rahul Marathe Rahul Taraman Marathe add - Manre hol tal chopda dist jalgao a/p Amdabad
Name of The Hospital to which he/she was removed Navjivan Hospital shirpur Dist dhule
Number of vehicle and type of the vehicle mini Track tata 407 MH-18-M-1787 2. Safari MH-19-BU-8096
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. Abhiman Govardhan More Age 48 add shirpur Adarsh Nagar Bhoi Galli shirpur dist dhule
Name of the owner of the vehicle as it stand on the date of the accident nil
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. nil
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate nil
Action Taken if any, and the result thereof. in
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