Accident Detail Receipt
Date And Time 01-Jan-1970 / 5:30 am
Place of Accident songir police station oposite NH-3
CR NO/ TAR No/ SDE NO 119/2017
Name of the Injured/ Deceased Pitambar Shantaram Patil and Narendar Pitambar Patil address- songir ,Dhule
Name of The Hospital to which he/she was removed civil hospital dhule
Number of vehicle and type of the vehicle 1)Bajaj Boxcer no.MH18 S 2698 2)Motor cycle no.MH18 BF8998
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)Bajaj Boxcer no. MH18S 2698 2) Motor cycle no. MH18 BF 8998
Name of the owner of the vehicle as it stand on the date of the accident Chandrakant krushna Gavli address- Varzadi ,shindkheda, Dhule
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Bajaj Company
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Bajaj company
Action Taken if any, and the result thereof. songir ps cr.119/2017 IPC 279,337,338,427 mv act184,119/177.
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