Accident Detail Receipt
Date And Time 08-Dec-2017 / 3:30 pm
Place of Accident On Dondaicha To Bamhane Road Near Railway Gate
CR NO/ TAR No/ SDE NO Cr No. 121/2017 IPC 304(A), 279, 337, 338, 427 MV Act 184,134/177
Name of the Injured/ Deceased Deceased - Ravindra Sahebrao Patil A/P Hol, Tal Shindkheda Dist. Dhule Injured - Bhartibai Ravindra Patil A/P Hol Tal- Shindkheda Dist - Dhule
Name of The Hospital to which he/she was removed Hire Medical Collage Dhule
Number of vehicle and type of the vehicle MH - 19 AM - 7699 Motor Cycle MH - 18 AA - 4338 Ashok Leyland LMV
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. Manoj Bhila Hire A/P Bamhane Tal. Shindkheda Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident Gopal Madhukar Suryawanshi A/P Kheddigar Tal Shahada Dist Nandurbar
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. The Oriental Insurance Company Dhule
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 182600/31/2017/3399 07/06/2017 To 18/09/2017
Action Taken if any, and the result thereof. Accused Produced Before Hon,Ble JMFC Court Dondaicha with CRPC 41 (1)(a)

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