Accident Detail Receipt
Date And Time 01-Nov-2018 / 10:00 am
Place of Accident Takarkheda shiwar in complainant farm
CR NO/ TAR No/ SDE NO CR No. 08/2018 IPC 304 (A)
Name of the Injured/ Deceased Deceased - Karunabai Ramesh Patil A/P Takarkheda Tal Shindkheda Dist Dhule
Name of The Hospital to which he/she was removed Civil Hospital Dondaicha
Number of vehicle and type of the vehicle Tractor No. MH - 18 - Z - 7084 With Thresher
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. Pradip Ananda Bagal A/P Nimgul Tal Shindkheda Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident Kantilal Tarachand Shinde
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Kotak Insurance Company
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 1019714500 09/11/2017 To 08/11/2018
Action Taken if any, and the result thereof. Issue Notice Of CRPC 41(1)(a) To Accused

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