Accident Detail Receipt
Date And Time 06-Aug-2018 / 10:30 am
Place of Accident Chalisgaon Chowfully, Dhule.
CR NO/ TAR No/ SDE NO Cr No.92/2018 IPC-279,337,338,427, M.V.Act 184 SDE NO.22/21.58
Name of the Injured/ Deceased 1.Sahebrao Trambak Mahajan 2. Ushabai Sahebrao Mahajan
Name of The Hospital to which he/she was removed Dr.Deore Hospital, Deopur Dhule
Number of vehicle and type of the vehicle MH.15 BE 1666, Honda Car
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. Nyanraje Balasaheb Desle add.rajapura Tq.Dindori, Dist-Nashik
Name of the owner of the vehicle as it stand on the date of the accident Gorkh baban Pawar
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. HDFC ERGO ADD.Jalgaon
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 2311201943304000003 Valid-12/10/2018
Action Taken if any, and the result thereof. ASI/F I Shaikh

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