Accident Detail Receipt
Date And Time 16-Dec-2017 / 4:30 pm
Place of Accident ner virdel gaon on road dondiacha to shindkheda road
CR NO/ TAR No/ SDE NO 143/2017 ipc 279 337 338 427
Name of the Injured/ Deceased injued - bashir meman momin
Name of The Hospital to which he/she was removed seva hospital dhule
Number of vehicle and type of the vehicle tata chota hatti no. mh-04gf-307 & motor bike mh-18ah-0186
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 bashir niman momin
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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