Accident Detail Receipt
Date And Time 25-Feb-2018 / 12:00 pm
Place of Accident NH-211 NEXT TO THE VILLAGE OF TARAWADE NEAR HOTEL SHIVRAJA
CR NO/ TAR No/ SDE NO DHULE TALUKA CR NO - 66/2018 IPC 279.337.338.427 SDE NO - 13
Name of the Injured/ Deceased 1.RIAJODIN ANIUDDIN SHAH 2.ASIF SHAH LAL SHAL 3.FAREED ADINODIN SHAH 4.SALIM NAZMUDDIN SHAH 5.AMINODIN HUSSAN SHAH 6.SHAIKH SAEED SHEIKH 7.FZZAN JAYNODDIN SHAH 8.ASLAM AZIZ SAHA 9.AMINIDDIN HUSNODDIN 10.SYED NOOR ALI NUSRAT ALI 11.NAZIM SHAH FAROOQ SHAH 12.GAFUR SHAH MEHBOOB SHAH 13.DANISH SHAH RIAZODIN SHAH 14.AARIF BABU SHAH 15.AYYAN SALIM SHAH 16.NAZIM HAMEED SHAH 17.SHAHID KHALIL SHAH 18.KHALIL AHMED JAMEEL AHMAD 19.JOINODEEN HUSNODIN SHAH 20.ALLAUDDIN SIKKDAR SHAH 21.KALIL SAMASUDDIN SHAH 22.FARHAN JAVED SHAH 23.WASIM SHAH SHAUKAT SHAH
Name of The Hospital to which he/she was removed CIVIL HOSPITAL DHULE
Number of vehicle and type of the vehicle MH-18-AA-5224 MH-14-AV-5942
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. --
Name of the owner of the vehicle as it stand on the date of the accident --
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. REG NO - 66/2018

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