|Accident Detail Receipt
| Date And Time
||11-Jul-2017 / 4:30 pm
|Place of Accident
||Tahrabad gavakadun pimpalner gavakade yet Astana shelbari ghatatil valnavar
|CR NO/ TAR No/ SDE NO
||108/2017 ups 304a,427 m v act 184
|Name of the Injured/ Deceased
||Maytache nav-dattatray barku gavli
|Name of The Hospital to which he/she was removed
|Number of vehicle and type of the vehicle
||Doshi vahan-st bus no m h 14 b t 2199
Pidit vyaktiche vahan no -mh 41 ad 6587
|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.
||Pravin subhash sonawane billa no 6413 vehan sakri depo
Licence no mh 1820090004795
|Name of the owner of the vehicle as it stand on the date of the accident
||Pravin subhash sonawane
|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.