Accident Detail Receipt
Date And Time 26-Mar-2018 / 6:30 pm
Place of Accident Parola Road Near Agriculture College Dhule.
CR NO/ TAR No/ SDE NO CR No 42/2018
Name of the Injured/ Deceased 1) Jayashri Dipak Kharal 2) Santosh Chagan Khatal 3) Satish Chagan Khatal 4) Mina Santosh Khatal 5) Suvarna Satish Khatal 6) Nikhil Vasant Kolekar All Add. Chitod, Dhule.
Name of The Hospital to which he/she was removed Unknown Private Hospital
Number of vehicle and type of the vehicle Mahindra Jeep Xuv 500 No- Mh 18 BC 7300 Dumper No-MH 18 BA 0619
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. Ananda Bharat Rokde Age-24 Add. Rokademala Chakkarbardi 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-42/2008 On Investigation

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