Accident Detail Receipt
Date And Time 05-Aug-2018 / 9:20 pm
Place of Accident sarvad area near bhgshree hotel national highway no 3 distnce from songir ps to accident place 4 km
CR NO/ TAR No/ SDE NO songir ps cr no 70/2018 ipc 279,337,338,427,MVACt. 184
Name of the Injured/ Deceased --
Name of The Hospital to which he/she was removed --
Number of vehicle and type of the vehicle 1) indica vista no-GJ-02-BH-4134 2) truk no-MH-18-AA-1979
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. 1)sanjay dhaulat jadhav age 49 at bhagava chuok avdhan dhule 2)
Name of the owner of the vehicle as it stand on the date of the accident --
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. arrest-gigarkumar rameshbhai parmar age at rohit nagar maisana (GJ) Date 17/5/2018 -time -14.47

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