Accident Detail Receipt
Date And Time 29-Sep-2017 / 5:30 am
Place of Accident Devbhane shivar opsit hotal Rajdhni MH-3
CR NO/ TAR No/ SDE NO 101/2017
Name of the Injured/ Deceased 1)Murlidhar Ramchandra Baviskar 2)Balvant Narayan Khothavde
Name of The Hospital to which he/she was removed civil hospital dhule
Number of vehicle and type of the vehicle 1) Trola no. MH04 TRMP44255
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)Trola no .MH04 TRMP 44255 varil driver
Name of the owner of the vehicle as it stand on the date of the accident non
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. tata company
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate tata company
Action Taken if any, and the result thereof. call 108 Ambulance
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