Accident Detail Receipt
Date And Time 16-Jun-2018 / 9:30 am
Place of Accident Near sangvi mumbai agra higway road namoshree petro.che north site
CR NO/ TAR No/ SDE NO 57/2018 ipc 279,337,338,427 Mv Act 184, 66/192
Name of the Injured/ Deceased 1) muntilal Shobharam Dabriya Age 22 2) prabhakar Sonawne
Name of The Hospital to which he/she was removed Cottege Hospital Shirpur
Number of vehicle and type of the vehicle 1) 407 gadi no. MH 04 W 9298 2) MH 04 EL 1861
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) prabhakar Somanath Shirsath A/p- Borajanti Tal Chopada Dist Dhule
Name of the owner of the vehicle as it stand on the date of the accident 2) LOTAN PATIL A/p- tulja bhawani Nagar CHOPDA TAL CHOPDA DIST- JALGAON, CHOPDA, JALGOAN
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. CHOLA MS Genaral Insurance
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 3379/02001784/000/00 date-30/03/2019
Action Taken if any, and the result thereof. submited to chargesheet in court

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