Accident Detail Receipt
Date And Time 01-Jan-1970 / 5:30 am
Place of Accident Nila Hotel Mumbai Agra Road Dhule
CR NO/ TAR No/ SDE NO Bhag 5 CR No 12/17 IPC 304A , 279,
Name of the Injured/ Deceased Mabhavraav popot patil
Name of The Hospital to which he/she was removed Shirpur Cottage Hospital
Number of vehicle and type of the vehicle Truck
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. Nil
Name of the owner of the vehicle as it stand on the date of the accident Nil
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. Nil
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate Nil
Action Taken if any, and the result thereof. An FIR has been registered against unkonown truck operator and onwer in Shirpur Shahar police Station

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