Accident Detail Receipt
Date And Time 01-Jun-2018 / 5:00 am
Place of Accident ABOVE GORANE FATA NO NH 03
CR NO/ TAR No/ SDE NO CR NO. 47/2018 IPC 304(A),279,337,338,427 MV ACT 118/177, 134/177
Name of the Injured/ Deceased DEAD- KAILASH BANSILAL PATIL AT- NAGAON TAI/DIST DHULE INJURY- DHARMESH RAMESH PATIL AT-NAGAON
Name of The Hospital to which he/she was removed CIVIL DHULE
Number of vehicle and type of the vehicle TRACKTOR NO. MH 18 Z 0299 PICK UP NO. MH 15 FV 1128
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. NIL
Name of the owner of the vehicle as it stand on the date of the accident NIL
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. NIL
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate NIL
Action Taken if any, and the result thereof. ON POLICE INVESTIGATION

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