Accident Detail Receipt
Date And Time 14-Aug-2017 / 6:00 pm
Place of Accident BETWEEN WARLA TO HIGOAN ROAD, NEAR HIVERKHEDA SHIWAR BESIDE ROAD ,NEAR TREE
CR NO/ TAR No/ SDE NO 66/2017 IPC 304 A, 279, 427,R/W MV ACT 184
Name of the Injured/ Deceased 1) sandeep darbar pawra age 27 add- higoan tal shirpur 2) bhaidas narsing barela age 30 add- devly tal warla dist- badwani m.p.
Name of The Hospital to which he/she was removed CIVIL (COTEAGE) HOSPITAL SHIRPUR
Number of vehicle and type of the vehicle 1) MP 46 MK 9665 HERO HF DELUX MOTOR CYCLE
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. NO LICENCE ISSU
Name of the owner of the vehicle as it stand on the date of the accident SANDEEP DARBAR PAWAR ADD- HIGOAN TAL- SHIRPUR DIST DHULE
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. NATIONAL INSURANCE COMPANY LIMITED
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate 39010231166201010599 VALID DATE- 04/06/2017
Action Taken if any, and the result thereof. ILLUP CHARGE SHEET COURT ABET FINAL
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