Accident Detail Receipt
Date And Time 06-Feb-2018 / 12:51 pm
Place of Accident Songir Area,Songir Dondaicha Road in front of medical board distance of songir police station 2 k.m western side
CR NO/ TAR No/ SDE NO 27/2018 IPC 279,337,338,427 MVAct 184,134/177
Name of the Injured/ Deceased 1) Ravindra Sitaram Jaware 2) Rajshree Ravindra jaware 3) Rugwade Ravindra jaware
Name of The Hospital to which he/she was removed Rural Hospital Songir tal Dist dhule
Number of vehicle and type of the vehicle 1) Apereshksha MH-02 Y A 5575,2) Motar cycle No MH-39 L 2396
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) Motar cycle No MH-39 L 2396 - Ravindra Sitaram Jaware 2) Pick Up MH-02 YA 5575 - Hussain Shaha Guffarshaha phakir age -27 at post Songir tal dist dhule
Name of the owner of the vehicle as it stand on the date of the accident 1) Motar cycle no MH-39 L 2396 Ravindra Sitaram Jaware 2) Pickup MH-02 YA 5575 Hussaim shaha Guffarshaha Phakir age-27 at post Songir tal dist dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. --
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate --
Action Taken if any, and the result thereof. Hussaim shaha Guffarshash Phakir age 27 arrest him 14.27

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