Accident Detail Receipt
Date And Time 24-Apr-2017 / 12:30 pm
Place of Accident Agrawal Nagar, opp. Mandaar Appartment, Dhule.
CR NO/ TAR No/ SDE NO Cr.No.20/2017 IPC-279,337,338, M.V.ACT 134/177 SDE NO.28/19.00
Name of the Injured/ Deceased Adnya Kiran Patil Age-06, Add-Agrawal Nagar, Dhule
Name of The Hospital to which he/she was removed Jagtap Hospital, Dhule.
Number of vehicle and type of the vehicle Hero Honda Pleasure MH.18 X 6195
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. Aakash Sanjay Jadhav age-18 Add.Agrawal Nagar Kalpatru Society, Dhule.
Name of the owner of the vehicle as it stand on the date of the accident Aakash Sanjay Jadhav age-18 Add.Agrawal Nagar Kalpatru Society, Dhule.
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. ASI/ V.C.MORE

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