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The accident occurred at Kanamala, near Erumeli, they said.
The pilgrims, hailing from Kolar in neighbouring Karnataka, were proceeding to the hill shrine located in Pathanamthitta district.
A senior official said as many as 43 people, including 40 pilgrims, were in the vehicle when it overturned after the driver lost control of it.
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Four injured pilgrims were rushed to the government medical College here, he said, adding that four persons were taken to the general hospital and some other accident victims were admitted to a nearby private hospital, the official added.