Accident Detail Receipt
Date And Time 27-Feb-2018 / 11:15 am
Place of Accident Lane No-4/5 Jingar Galli, Dhule.
CR NO/ TAR No/ SDE NO CR No.32/2018
Name of the Injured/ Deceased Bedi Vinodkumar Jain Age-53 Add. Galli No-5 House No.2614 Dhule
Name of The Hospital to which he/she was removed Mutha Accident Hospital Dhule.
Number of vehicle and type of the vehicle Maruti Eco No-MH-18 AJ 2327
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. Paras Humukchand Jain @ Ganesh Jain Age-39 Add. Lane No.4/5 House No.2836/2 Gingar Galli Dhule. JB Road Dhule.
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. CR No-32/2018 STC No.1525/2018 Court Pending

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