Accident Detail Receipt
Date And Time 12-Apr-2018 / 3:15 am
Place of Accident Shirpur Chopada Road Var Military School Near
CR NO/ TAR No/ SDE NO 21/2018 STE No 17/18.15
Name of the Injured/ Deceased Injured Name - Ashwin Premaji Solanki Age 22 At.Post.Mandwada Tal.Anjad Dist Badwani Death Name- Omprakash Yashwant Darbar At.Post Mandwada Tal Anjad Dist Badwani. Death Name - Harish Pratap Solanki At.Post Mandwada Tal Anjad Dist Badwani
Name of The Hospital to which he/she was removed Cottage Hospital Shirpur Dist Dhule
Number of vehicle and type of the vehicle Hundai Company Car No MP 09 CM 1910
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. Madhya Pradesh State Issued On Date 26-07-2016 RTO Surendra Baromya
Name of the owner of the vehicle as it stand on the date of the accident Rahul Surendra Darbar C/O Yadhav Chakki Peche 301/3 Bhagirathpura
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Cholomadalam General Insu Company Bhopal Brach Office Plot no 165A,Zone 1st Floor MP Nagar Bhopal MP 462011
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 3362/01482737/000/00 19-02-2018 To 18-02-2019 Midnight
Action Taken if any, and the result thereof. ---

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