Accident Detail Receipt
Date And Time 11-Apr-2018 / 3:30 pm
Place of Accident palasner goan area mumbai agra hiaway suni petron pump behind
CR NO/ TAR No/ SDE NO Cr No 31/2018
Name of the Injured/ Deceased 1) raju kalyan yadav age 35 Add- muradabad u.p. 2) navabsing sompalsing age 27 muradabad u.p.
Name of The Hospital to which he/she was removed coteage hospital shirpur
Number of vehicle and type of the vehicle 1) MH 18 AA 6446
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. PRABHU BAGHEL Add- Sitaram Village Rewaa Bujurg teh Rajpur Dist Badwani MP issuing Authority-Brwani Rto MP
Name of the owner of the vehicle as it stand on the date of the accident 1) MH 18 AA 6446- Oner name- MR. kalimula Abdulla MansuriA/P- 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. The New India Assurance Co.Ltd.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate POlicy No- 71070031170100017376 valid Date-5/10/2018
Action Taken if any, and the result thereof. Chargesheet Fill up court

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