Accident Detail Receipt
Date And Time 21-Apr-2018 / 3:30 am
Place of Accident Karachiwala Khunt, Dhule.
CR NO/ TAR No/ SDE NO CR No.49/2018
Name of the Injured/ Deceased 1) Manoj Uttamrao Mahajan 2) Asgarali Akbarali (Above Both Patient Transfer From Rasiklal Patel Medicle Foundetion College, Shirpur.)
Name of The Hospital to which he/she was removed Astha Hospital, Malegaon Road Dhule.
Number of vehicle and type of the vehicle Ambulance No.MH 18 AA 801 Rajkamal Travel's Bus No- GJ 03 BT 9015
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. Mukeshbhai Bhimabhai Renuka Age-40 Add. Sarsiya Tal.Dist Amreli (Gujrat)
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-49/2018 On Investigation

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