Accident Detail Receipt
Date And Time 10-Jan-2017 / 5:30 am
Place of Accident Dapora shivar songir to dapora road dhule
CR NO/ TAR No/ SDE NO 103/2017
Name of the Injured/ Deceased Pankaj Vasant Patil age-23 and Rekhabai Vasant patil age-40 address- Dapora ,songir dhule
Name of The Hospital to which he/she was removed songir hospital gov.
Number of vehicle and type of the vehicle Honda Activa and pulser
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. Bajaj pulser
Name of the owner of the vehicle as it stand on the date of the accident Vijay Ramkrushn patil address- dapora ,near songir dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Bajaj pulser
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Bajaj pulser
Action Taken if any, and the result thereof. They are go to songir
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