Accident Detail Receipt
Date And Time 04-Jul-2018 / 4:30 am
Place of Accident Nageshwar Bangala village Near Nageshwer Temple chya Roadvar
CR NO/ TAR No/ SDE NO 29/2018 STD.No 21 21.40
Name of the Injured/ Deceased Death Name :- Hiralal Ukha Koli At Post Bhatpura Tal Shirpur Dist Dhule Injured Name:- Ravindra Munna Pawara 2) Ravindra Bhil
Name of The Hospital to which he/she was removed Cottage Hospital Shirpur
Number of vehicle and type of the vehicle 1) MH 18 BF 6853 2) MH 18 AG 3647
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. 1)Mahendra Dhaku Akhadmal RTO Nashik Issuing Of Authourity --
Name of the owner of the vehicle as it stand on the date of the accident Mansaram Bhalal Bhil At Post Ajnad Tal shirpur Dist Dhule 2) Yogest Vasant Koli At Post Hingoni Tal Shirpur Dist Dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. 1) -- 2) BajajAlilaz Central Insurance Company Limited
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate --- 2) Policy No OG 18 10006401 00220589 Insurance Period Of Date 12-July 2017 To 12 July 2018 Midnight
Action Taken if any, and the result thereof. Criminal Arrest

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