Accident Detail Receipt
Date And Time 26-Jun-2017 / 6:00 pm
Place of Accident mumbai agra high way no 3 near by ajande village
CR NO/ TAR No/ SDE NO shirpur city ps cr no 152/2018 ipc 279, 337, 338, 427, m v act 184, 133/177
Name of the Injured/ Deceased ramabai byansing pawara, demnya pawara, alladin pawara, vinod pawara all add. sendwa mp
Name of The Hospital to which he/she was removed cottage hospital shirpur
Number of vehicle and type of the vehicle 1) mahindra maxx mp 46 ba 4209 2) tata truck hr 38 v 7890
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. arvind kumar netrapalsing add. ramai post mirehachi dist etah up RTO ETAH lic no. up82-20090008627 valid. 03/07/2020
Name of the owner of the vehicle as it stand on the date of the accident 1) amjad khan vill. badibijasan tal sendwa dist badwani mp 2) m/s in india cargo movers add. prop sarvesh pandey, sco-296 sec 58 transport nagar faridabad hr
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. 1) national insurance company add. mangal nagar behind sbi bank dhamnod 2) universal sampo general insurance co ltd add. unit 401 4 th floor sangam complex 127 andheri kurla road andheri east mumbai
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 1) 320404371003999 valid. 23/01/2018 to 22/01/2019 2) 201504364309 valid. 21/10/2017 to 20/10/2018
Action Taken if any, and the result thereof. investigation proceed

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