Accident Detail Receipt
Date And Time 22-Oct-2017 / 7:30 pm
Place of Accident nirgudi shivar shindkheda & varshi on road
CR NO/ TAR No/ SDE NO 129/2017 ipc 304(a)279 337
Name of the Injured/ Deceased manoj bapu bhamre Age-26
Name of The Hospital to which he/she was removed hire medical dhule
Number of vehicle and type of the vehicle motor bike-mh-18ar-3963 & mh-18bb-8521
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. manoj bapu bhamre
Name of the owner of the vehicle as it stand on the date of the accident unknown
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. unknown
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate unknown
Action Taken if any, and the result thereof. rigerdterd FIR

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