Accident Detail Receipt
Date And Time 01-Jan-1970 / 11:30 am
Place of Accident Anjanshah baba darga samor rodvar dhule.
CR NO/ TAR No/ SDE NO dhule city cr. no.03/2018 Ipc 279,337,338,427,mvact-184,134/177
Name of the Injured/ Deceased 1) Rajendr Arjun mahajan -35 ??. 35/B Vishal Estet mil parisar dhule 2) Vijay Bapu more -??.?? ???????.
Name of The Hospital to which he/she was removed Dr.Zende Hospitel dhule
Number of vehicle and type of the vehicle MH.18.BB.6907 & unnone 3 vilar vehicle .
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. Unnone
Name of the owner of the vehicle as it stand on the date of the accident Unnone
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. ---------

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