7. Particulars required for filing claims in Railway Claims Tribunal
1.Name and father’s name of the person injured/dead (husband’s name in the case of married woman or widow).
2. Full address of the injured / dead.
3. Age of the person injured / dead.
4. Occupation of the person injured / dead.
5. Name and address of the employer of the deceased, if any.
6 .Brief particulars of the accident indicating the date and place of accident and the name of the train involved.
7.Name and permanent address of the applicant
8.Local address of the applicant, if any.
9.Relationship with the deceased / injured.
10.Amount of compensation claimed.
11.Where the application is not made on time one year of the occurrence of theaccident,the grounds thereof.
12.Any other information or documentary evidence that may benecessary orhelpful in the disposal of the claim
13.Class of travel, and ticket / pass number, to the extent known.
14.Nature of injuries sustained along with medical certificate.
15.Nameandaddress of the Medical Officer / Practitioner; if any, whoattendinjured/deadand periodof treatment.
16.Disability for work, if any, caused.
17.Details of the loss of any luggage on account of the accident.
18.Has any claim been lodged with any other authority if so particulars thereof.
