Accident Detail Receipt
Date And Time 07-Jul-2017 / 10:00 pm
Place of Accident In Dondaicha Near Police Station
CR NO/ TAR No/ SDE NO Cr No. 111/2017 IPC 304(A), 279,427
Name of the Injured/ Deceased Deceased - Anil Purushotam Sonar
Name of The Hospital to which he/she was removed ----
Number of vehicle and type of the vehicle MH - 18 AS- 7750 TVS Jupiter Scooter
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. Anil Purushottam Sonar A/P Jinwala Compound Dondaicha Tal Shindkheda Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident Anil Purushottam Sonar
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. Abate Final On Deceased Accused Anil Purushottam Sonar

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