Accident Detail Receipt
Date And Time 08-Apr-2018 / 12:30 pm
Place of Accident Chalisgaon Road, Opp.Dhuliya Gairage, Dhule.
CR NO/ TAR No/ SDE NO Cr.No.58/2018 IPC-279,337,338,427, M.V.Act 184 SDE No.06/12.35
Name of the Injured/ Deceased Wajid Shaikh Sikandar Age-21, Add-Jamcha Mala , Chalisgaon Road, Dhule.
Name of The Hospital to which he/she was removed Rajesh Patil Hospital, Dhule.Sahil Javeed Pinjari Add-Jamcha Mala , Chalisgaon Road, Dhule.
Number of vehicle and type of the vehicle 1.Mini Truck No.MH.18 4116 2.Hero Honda motar Cycle No.MH.18 AB 5373
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. Sahil Javeed Pinjari Add-Jamcha Mala , Chalisgaon Road, Dhule.
Name of the owner of the vehicle as it stand on the date of the accident Sayyed Shaikh Sikandar, Add-Jamcha Mala , Chalisgaon Road, Dhule.
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. ICICI Lombard Motar Insurance Co.LTD.
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 3005/34092393/10926/000 Valid-18/10/2018
Action Taken if any, and the result thereof. NPC/160 P.B.Nandale

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