| 1. |
Police Station Name. |
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MANGAON POLICE STATION |
| 2. |
CR No. |
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Cr 108/2018 IPC 279,337,338 mv act 184 |
| 3. |
Accident No. |
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NULL |
| 4. |
Date,Time And Place Of Accident |
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2018-06-20 , 17:45 , at kashene village mumbai goa highway |
| 5. |
Name of Injured/Deceased |
:- |
1)Amruta Prashant Shukla 2)Digvijay Subhash Karvekar3)Vilas Shashikant Tavate 4)Shweta Digvijay Karv |
| 6. |
Name of the Hospital to Which He/She Was Removed |
:- |
NIL |
| 7. |
Number Of Vehical and type Of the Vehical |
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2 , car |
| 8 |
Name and Address Of the Driver Of the
Vehical With Particulars Or Driving License
Of the Said Driver And the Address Of
Issuing Autdority Of the Said Driving
License.the Number Of Badge in Case
Of Public Service Vehical and Address of
Issuing Autdority Of the Said Badge |
:- |
Vilas Shashikant Tavate At ulave panvel |
| 9. |
Name And Address Of the Owner Of the Vehical As It Stand On the Date Of Accident |
:- |
Unknown,unknown |
| 10. |
Name And Address Of the Insurance Company With Whome the Vehical Was Insured And the Divisional Office Of the Said Insurance Company. |
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Null , Null , Null |
| 11. |
Number Of Insurance Policy/Insurance Certificate And the Date Of Validity Of the Insurance Policy/Insurance Certificate. |
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Null,0000-00-00 , 0000-00-00 |
| 12. |
Action Taken, If Any, And the Result thereof |
:- |
r 108/2018 IPC 279,337,338 mv act 184 Registered at mangaon police station |
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N.B.-tdis from should accompany witd all necessary document viz. (1)F.I.R (2)Panchanama
(3) Medical Certificate/Post-Mortem Report. |
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Inspector of police,
...........Police Station. |