ELECTRICAL ACCIDENT REPORTING

Complainant Name* Mobile No*
Accident Details
Victim Type*      Human    
       Animal
Accident Type*      Fatal
       Non-Fatal
Date*
Time*
Accident Occurred on*      HT    
       LT
       DTR
Name*
Father Name*
Age*
 
Type & No.of Animal(s)
Cow
Calf
Buffalo
Bull
Ox
Goat
Sheep
Horse
Camel
Donkey
Domestic Pig
Name(s) of Legal Heirs
(i)
(ii)
(iii)
(iv)
Accident Location
H.No.*
Street*
District*
Mandal*
Village*
Communication Address
H.No.*
Street*
District*
Mandal*
Village*
Tel.Phone.No
Email
List of Documents
(i)    Documents reflecting the ownership of animal issued by local bodies*
(ii)   A copy of post mortem issued by the Govrnment veterinatry doctor*
(iii)  A copy of panchnama if conducted by local bodies*
(iv)  A copy of photo exhibiting the death of animal(s).*
(v)  Signature*
List of Documents
(i)    A copy of First Information Report of Police department*
(ii)   A copy of Post Mortem Report issued by a Government Doctor*
(iii)  A copy of Panchnama issued by Police department*
(iv)  Copy of Death Certificate*
(v)  Signature*
ownership
postMortem
panchanama
Photo
Sign