Accident Detail Receipt
Date And Time 28-Nov-2017 / 5:00 am
Place of Accident on road dondiacha to songir near darane fata
CR NO/ TAR No/ SDE NO 139/2017 ipc304 (a) 279 337 338 427 mv ACt-184
Name of the Injured/ Deceased dvarkabai kema marathe he is deceased
Name of The Hospital to which he/she was removed pimparde teh-shahada dist.nandurbar
Number of vehicle and type of the vehicle tampo 407 no.mh-215143
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. unknown
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. rigestered

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