Accident Detail Receipt
Date And Time 22-Jul-2018 / 10:00 pm
Place of Accident Chalisgaon Road, Opp.Sahara Service Station, Dhule.
CR NO/ TAR No/ SDE NO Cr.No.81/2018 IPC-279,337,338, M.V.Act 184, 134/177 SDE No.14/20.47
Name of the Injured/ Deceased Bhikan Shamser Pinjari Age-48, Add-Jamcha Mala, Chalisgaon Road, Dhule.
Name of The Hospital to which he/she was removed Seva Hospital, Dhule.
Number of vehicle and type of the vehicle Hero Honda Splender MH.18 AG 9515
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. Shaikh Faimuddin Shaikh Chiraguddin Age-44, Add-H.No.122, Hajarkholi, Near Madni Masjid, Dhule.
Name of the owner of the vehicle as it stand on the date of the accident Shamim Akhtar Chiraguddin Shaikh, Add-H.No.122, Hajarkholi, Garib Nawaj Nagar, Near Madni Masjid, Dhule.
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Reliance General.co.in
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 110321823480028156 Valid-17/04/2019
Action Taken if any, and the result thereof. PSI/ S.B.Aher

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