Accident Detail Receipt
Date And Time 27-Jul-2018 / 8:00 pm
Place of Accident Shirpur Chopada Road Var Nikan Poulad Shirsath Yanchya Seta Javad
CR NO/ TAR No/ SDE NO 35/2018 IPC 304(A),279,337,338,427 MV ACT 184,134/177 SDE NO 16 13.30
Name of the Injured/ Deceased Name Of Death :- Sahebrov Chena Banjara At Post Bablaj Tal Shirpur Dist Dhule
Name of The Hospital to which he/she was removed Sidheswer Hospital Dhule (P M Civil Hospital Dhule)
Number of vehicle and type of the vehicle 1) Mahindra Maxx Passanger MH 18 N 5936 2) Motar Cycle No MH U 1966
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)Suresh Lakha Jadhav At Post Ajnad Bangala Tal Shirpur Dist Dhule Issuing Authority Dhule RTO 2) Sahebrov Chena Banjara At Post Bablaj Tal Shirpur Dist Dhule Issuing Authority Dhule RTO
Name of the owner of the vehicle as it stand on the date of the accident No
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Policy Schedule Cum Cartificate Of Insurance Policy Number 16080631170200000307 Period 06/01/2018 To 05/01/2019 PM
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Policy Number 16080631170200000307 Period No 06/01/2018 To 05/01/2019 PM
Action Taken if any, and the result thereof. Criminal Arrest

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