Accident Detail Receipt
Date And Time 07-Apr-2018 / 7:26 pm
Place of Accident Kapdane Area,kapadne -Devbhane Road distance from songir ps 10 k.m eastern
CR NO/ TAR No/ SDE NO Songir ps C.R.NO 59/2018 IPC 279,337,338,427,MVact 184
Name of the Injured/ Deceased 1) Pandit Jyotiram Mali age 55 (2)sumanda jyotiram mali age 50
Name of The Hospital to which he/she was removed rural Hospital songir tak dist dhule
Number of vehicle and type of the vehicle (1)trcter no mh-18-z-9836 (2)motar cycle no mh-AG -2954
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. kishor lotan mali Age 31 at kapdne tak dist dhule Trcter no mh 18-z-9836 pandit jyotiram mali age 55 at kapdne tal dist dhule motar cycle no mj-18AG-2954
Name of the owner of the vehicle as it stand on the date of the accident kidhor lotan mali age 31 kapdne tal dist dhule trcter no mh-18-z9836 pandit jyotiram mali age 55 at kapdne tal dist dhule motar cycle no -mh AG-2954
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. crpc-41(A) notice issued kishor lotan mali

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