Accident Detail Receipt
Date And Time 04-Dec-2017 / 12:30 pm
Place of Accident shindkheda to chimthana on road near relwe station
CR NO/ TAR No/ SDE NO 140/2017 ipc 304(a) 279 338 427 mv ACt-184
Name of the Injured/ Deceased Deceased - sunil vitthal gurav Age-30
Name of The Hospital to which he/she was removed rural hospital shindkheda
Number of vehicle and type of the vehicle isher truck no mh-18m-6696 &^ motor bike mh-18 X-7924
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 self complented
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 FIR

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